UWBC VBS

Vacation Bible School Registration Form
STUDENT INFORMATION
Child's Name

First NameLast Name
Age
Gender
Last grade completed in school
Have you attended VBS before?
Home Church (if any)
If you are visiting for the for the first time, who are you a guest of?
EMERGENCY CONTACTS
Primary Guardian

First NameLast Name
Relationship to child
Phone Number
Format: (000) 000-0000.
Alternate Guardian #1

First NameLast Name
Relationship to child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Who may pick your child up each day?
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)
Please list all medical concerns -- or type "none" if there are none
Additional Information
VBS photos/videos are taken for promotional purposes related to UWBC and Vacation Bible School. These pictures appear in various media outlets such our UWBC church app and our Facebook page. Do you allow your child to be included in these photos/videos?
T-shirt Size
By submitting this form, I ackowledge I have read and understand the above information.
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Vacation Bible School Registration Form