VBS 2017 Registration - Passport to Peru
Join us at Calvary Bristol for five nights of adventure July 17-21 from 6:30 p.m. to 8:30 p.m. Please fill out one form for each child who will be attending VBS.
Child Information
Child's First Name
Your answer
Child's Last Name
Your answer
Child's Street Address
Your answer
Parent/Guardian First and Last Name
Your answer
Parent/Guardian Email Address
Your answer
Parent/Guardian Contact Phone Number
Your answer
Child's Birthday
MM
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DD
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YYYY
Child's age by July 17
Your answer
Last school grade child completed
Gender of child
Medical Information
Does your child have any health issues, physical limitations, medical conditions or behavioral needs that may impact or limit their participation in VBS activities?
If yes, please specify
Your answer
Does your child have any allergies or diet restrictions?
If yes, please specify
Your answer
Additional Special Instructions
Your answer
Emergency contact name during hours of VBS
Your answer
Emergency contact phone number during hours of VBS
Your answer
Emergency contact relationship to child
Your answer
Additional Information
How did you hear about Calvary's VBS program?
Required
Are you looking for a church home?
Photo Release
By signing this form I understand that my child may be photographed for the use of Calvary Baptist Church Bristol. I give permission to copyright, use and publish the photographs for any lawful purpose including, but not limited to, church publications and the church website.
Medical Release
By signing this form I release adult supervisors and Calvary Baptist Church Bristol from responsibility for accidents during church sponsored activities. In case of emergency, I, the parent/legal guardian of the above mentioned minor, give permission to the adult sponsors of Calvary to secure proper treatment for the health and comfort of my child until I can be reached.
Parent/Guardian e-Signature (please enter your name)
Your answer
Date Signed
MM
/
DD
/
YYYY
Submit
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