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Chef Registration Form
Please fill out a form for each child separately!
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* Indicates required question
Student’s Name
*
Your answer
Parent/Family/Guardian Name
*
Your answer
Address
*
Your answer
E-mail Address
*
Your answer
Phone Number
*
Your answer
Date of birth
*
MM
/
DD
/
YYYY
Age
*
Your answer
Last school grade completed
*
Your answer
Home Church
Your answer
Friends of your child at this church
Your answer
Special Needs/Allergies/Medical Information/Other
*
Your answer
Emergency Contact #1
Name
Phone
Relation to child
*
Your answer
Emergency Contact #2
Name
Phone
Relation to child
*
Your answer
Name(s) of person(s) who may pick up this child from VBS
*
Your answer
Photo Release:
Connect4Life Church/VBS has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use
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