VBS - Live it Out!
July 7th - 11th, 6-8 pm *Please note one form per child must be filled out.
Participant's Name
*
First Name
Last Name
Grade Completed
*
Are there any allergies or Medical Conditions we need to be aware of?
*
Photo Release Authorization
*
I permit photographs of my child to be taken and used on our social media pages?
NO - I DO NOT WANT PHOTOS OF MY CHILD TAKEN
Parent/Guardian's Name
*
First Name
Last Name
Phone Number
*
Please note that we must be able to reach you while your child is in our care. Please be sure your phone is on and the volume is turned up. Thank you.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Submit
Should be Empty: