Vacation Bible School Registration

Emergency Contact Name:*

First NameLast Name
Emergency Contact Phone:*
Relationship to child*
In case of an emergency I give permission for VBS staff to call 911*

YesNo
Allergies (if yes list below):*
Name of Person Picking up Child:*
Photographs will be taken during VBS. I am giving permission for my child’s photo to be taken*

YesNo

We are excited to have your child here at VBS!

We believe that every child has God-given strengths and abilities. We would love to get to know your child better in order to encourage these strengths and abilities as well as to support them in the areas where they may need additional help. Please fill out the form below so we can get to know your child better
My child has the following educational label or medical diagnosis:
My child’s primary means of communication is:
Additional information concerning my child’s allergies or food sensitivities:
My child’s favorite activities and interests are:
My child avoids doing or becomes easily frustrated with the following activities:
If my child becomes overwhelmed or frustrated they will respond best to:
My child’s strengths are:
My child needs help with:
What suggestions do you have that may help us create the best possible experience for your child?
What information would you like us to share with other children at VBS that will help them to better know, accept and understand your child?
Name:*

First NameLast Name
Date

MonthDayYear
Date

VBS Registration Form