Vacation Bible School 2024

Vacation Bible School 2024

August 5 - 9, 2024. Optional meal 5:30 - 6:00PM. VBS 6:00-8:30PM.
CHILD INFORMATION (One child per form):
Child Name*

First NameLast Name
Grade Completed*
Birthday*

MonthDayYear
Date
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone*

Area CodePhone Number
Cell Phone

Area CodePhone Number
E-mail*
Primary Person Bringing Child*

First NameLast Name
Primary Person Taking Child Home*

First NameLast Name
Phone Number of Primary Person Taking Child Home*

Area CodePhone Number
List other people dropping off or picking up the child, if it is different per day. Include contact's phone number.
Church Affiliation/Membership
MEDICAL INFORMATION
Emergency Contact Person

First NameLast Name
Relationship to child
Emergency Contact Phone

Area CodePhone Number
Emergency Contact also Attending VBS?

NoYes
Allergies (If none type N/A)*
Medical Concerns (If none type N/A)*
An optional free meal will be served prior to VBS from 5:30 - 6:00 PM. Will your child be participating in the meal?*

Yes, child will eat meal.No, child will not be eating meal.
Should be Empty: