SHIPWRECKED: RESCUED BY JESUS FBC VBS 2018
Thank you for registering your child for Shipwrecked: Rescued by Jesus 2018!

Our VBS will be held Monday, June 4 - Friday, June 8, from 5:45. - 8:45 p.m.
A child must be 3 years of age by August 1, 2017 to attend VBS. Children who have completed 5th grade can attend.

Younger children can be left in our worker's nursery, but a parent must stay on-site and be working in VBS.

Our Shipwrecked Kick-Off will be held Sunday, June 3 at 6:00 p.m. in our Sanctuary.

Thanks again for taking the time to register! Note that each child must be registered on a different form.

Questions? Contact Rachel Cobb, Director of Preschool & Children's Ministries at rachel.cobb@firstbaptistnet.com or 623-4028, ext. 212.

(NOTE: Please use the TAB key to move to the next field. If you press ENTER by mistake, once you move past the required fields, you will not be able to complete the registration.)

Child's Last Name *
Your answer
Child's First Name *
Your answer
Gender *
Required
Child's Date of Birth *
(MM/DD/YYYY)
Your answer
Allergies or Medical Conditions
Please list anything we should be aware of, including food allergies.
Your answer
Home Street Address *
Your answer
Home City *
Your answer
Home Zip *
Your answer
Mother's/Guardian's Name *
Your answer
Mother's/Guardian's Primary Phone *
Your answer
Mothers/Guardian's Email
Your answer
Father's/Guardian's Name
Your answer
Father's/Guardian/s Primary Phone
Your answer
Father's/Guardian's Email
Your answer
Pick-Up Information
Should Mother be a designated pick-up person?
Should Father be a designated pick-up person?
Other adults authorized to pick-up child?
List up to 3 names
Your answer
Emergency Contact Information
Emergency contact (other than parent/guardian) *
Your answer
Emergency contact's primary phone *
Your answer
Relationship of emergency contact *
Your answer
Miscellaneous Information
Grade Completed by June 2018
Your answer
School attended?
Your answer
T-Shirt Size
Does your child have a preferred crew leader?
Please list person's name
Your answer
Is there another child your child would like to be in a crew with?
Please list child's name
Your answer
Is child a Christian?
Is child/family members of a local church?
If so, what is church name?
Your answer
Additional comments or information you want us to know.
Your answer
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