2018 CVBS Baltimore Child Registration
Dates: July 9-13, 2018
Questions: contact: Lindsey Feldman at lfeldman@allsaintswoodbridge.org, or
Michelle Chase at mchasehomes@gmail.com
Email address *
Which site will your child attends?
Child's last name *
Your answer
Child's first name *
Your answer
Child's date of birth *
MM
/
DD
/
YYYY
What grade did child last finish in school? *
Parent/Guardian full name *
Your answer
Preferred phone number *
Your answer
Medical Information (Please include any food or drug allergies. Write "none" if none) *
Your answer
Who may pick up your child? (please only list up to 3 names) *
Your answer
May your child walk home from VBS? *
May your child be included in a group photo for a take home souvenir? *
May we have permission to use your child's photograph in Community VBS publications, with no identifying information, for the purpose of promotion? *
Child's T-shirt size (mark only one) *
Emergency Contacts
Contact 1 Name *
Your answer
Contact 1 Phone number *
Your answer
Contact 2 Name
Your answer
Contact 2 Phone number
Your answer
Child's Address (include street, city, state & zip) *
Your answer
Church affiliation, if any
Your answer
A copy of your responses will be emailed to the address you provided.
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