Grace Hill Church 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 Grace Hill Church 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.
Your answer
Please note: Grace Hill Church 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.
Your answer
**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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