Vacation Bible School 2024
Elders Baptist Church; 1216 Liberty Rd. Sykesville, MD
Parent/Guardian #1
*
First Name
Last Name
Parent/Guardian #2
First Name
Last Name
Email
*
example@example.com
Phone Number: Primary
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Child #1
First Name
Last Name
#1 Birthday
-
Month
-
Day
Year
Date
#1 grade
Allergies/Medical/Education concerns #1
Child #2
First Name
Last Name
#2 Birthday
-
Month
-
Day
Year
Date
#2 grade
Allergies/Medical/Education concerns #2
Child #3
First Name
Last Name
#3 Birthday
-
Month
-
Day
Year
Date
#3 grade
Allergies/Medical/Education concerns #3
Child #4
First Name
Last Name
#4 Birthday
-
Month
-
Day
Year
Date
#4 grade
Allergies/Medical/Education concerns #4
Pictures and video's permitted for VBS (including private FB group, church website, slideshows and boards).
*
YES
NO
I agree to KEEP MY CHILD(REN) HOME if they are exhibiting any of the following symptoms: fever, excessive cough, shortness of breath, aches & pains, diarrhea, vomiting, until they have been symptom free for a period of 2 days
*
YES
NO
Emergency Contact (after we attempt to contact parents)
First Name
Last Name
Emergency Contact Phone
Would you like to purchase VBS t-shirts? (price TBD; average $15) Please list how many and what sizes you would like.
Other notes for leaders or questions:
I will be onsite with my child during VBS
YES
NO
I will be onsite volunteering at VBS
YES
NO
Sometimes
I not be onsite during VBS
YES
NO
Sometimes
Register
Should be Empty: