VBS Online Registration - Upward Bound 2017
All children who have completed grades 4K-6th are welcome to attend.
Parent(s) First & Last Names
Your answer
Did anyone invite you to VBS? If so, whom?
Your answer
Child's Name (#1)
Your answer
Grade Completed
Birthdate
Your answer
Child's Name (#2)
Your answer
Grade Completed
Birthdate
Your answer
Child's Name (#3)
Your answer
Grade Completed
Birthdate
Your answer
Child's Name (#4)
Your answer
Grade Completed
Birthdate
Your answer
Phone Number (Best # to reach you during VBS)
Your answer
Alternate Phone Number
Your answer
Address
Your answer
E-mail Address
Your answer
If your family regularly attends church, where do you attend?
Your answer
Emergency Contact (other than parent)
Your answer
Emergency Contact Primary Phone Number
Your answer
Emergency Contact Secondary Phone Number
Your answer
Medical Release Information
Doctor's Name(s)
Your answer
Doctor's Phone Number
Your answer
Allergies? Please list child's name and any allergies.
Your answer
Any additional information or special needs?
Your answer
In case of a medical emergency, I hereby give permission to First Baptist Church of Merton to secure proper treatment or hospitalization for the child(ren) on this registration form.
*Your typed signature on this form gives us permission in case of emergency.
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Please note: First Baptist of Merton will make every attempt to reach the parent(s)/guardian(s) or the emergency contact(s) given on your registration form.
If you have any special concerns regarding an emergency, please let us know.
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**I am aware there will be a "Summit Celebration" (closing program) from 3:20-3:45 p.m. on Friday. Parents are encouraged to join us.
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