2024 Calcedonia Baptist VBS Registration Form

2024 Calcedonia Baptist VBS Registration Form

July 7 thru 11, 5:45pm to 8:00pm, 3 years old thru 6th grade
Institution Name
STUDENT INFORMATION (will need to fill out a form for each child)
Name*

First NameLast Name
Preferred name if different than above
Birth Date *

MonthDayYear
Date
Gender
Grade going into in August 2024*
Home Church (if any)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Please enter a valid phone number.
Secondary Phone Number
Please enter a valid phone number.
EMERGENCY CONTACTS
Please list the first and last names and phone numbers off ALL adults who are allowed to pick up this child. The child will only be released to these people.
Primary Guardian*

First NameLast Name
Relationship to child*
Phone Number*
Alternate Guardian #1*

First NameLast Name
Relationship to child*
Phone Number*
Alternate Guardian #2

First NameLast Name
Relationship to child
Phone Number
When picking up your child, a password will be required. Please provide the password you would like us to use. Anyone picking up your child will be required to provide the password and if unknown, we will have to call the guardian provided to come pick them up. *
Medical Information
Please list all allergies -- or type "none" if there are none*
Does your child carry an epi-pen? (please note: if yes, it is the responsibilty of the child's guardian to ensure the child has the epi-pen at every drop off and pick up)*

YesNo
Please list all medical concerns -- or type "none" if there are none*
Additional Information
VBS photos/videos are taken at Vacation Bible School and posted to our church social media (facebook). Do you allow your child to be included in these photos/videos?*

YesNo
Please provide any additional information we should know about your child.
By submitting this form, I ackowledge I have read and understand the above information.
Signature

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2024 Calcedonia Baptist VBS Registration Form

Medical Information

Additional Information