Vacation Bible School Registration Form
Name *
Your answer
Address *
Your answer
Home Phone *
Your answer
E-mail Address *
Your answer
Age *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Last school grade completed *
In case of emergency, contact *
Your answer
Mother's Name *
Your answer
Father's Name *
Your answer
Siblings at VBS *
Your answer
Allergies or other medical conditions: *
Your answer
Home Church *
Your answer
I grant permission to Immanuel for the use of the photograph(s) or electronic media images taken during VBS in any presentation of any and all kind whatsoever. I understand that I may revoke this authorization at any time by notifying the church in writing. The revocation will not affect any actions taken before the receipt of this written notification. Images will be stored in a secure location and only authorized staff will have access to them. They will be kept as long as they are relevant and after that time destroyed or archived. *
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