Participant's Name
*
First Name
Last Name
What grade will you be in when school starts?
Please Select
Pre-K
Kinder
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
College
n/a
I am registering as a:
Please Select
VBS Leader/Staff
VBS Attendee
Teacher (approval required)
Arts & Crafts Volunteer (approval required)
Kitchen Volunteer
Parent/Guardian Name (enter n/a if not applicable)
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email Address
*
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Does the participant have any allergies or medical conditions?
By attending and participating in this event, you grant permission for your image, likeness, and voice to be captured in photographs and video recordings. You authorize Pilgrim Rest Missionary Baptist Church to use these materials for promotional, marketing, and communication purposes in print, digital, and social media, without compensation.
*
Yes
No
Register
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