VBS Registration

Parent/Guardians Name-Nombre de Guardian Principal

First NameLast Name
VBS JUNIO 17-19 6:00PM to 8:00PM
Child's Name/Nombre de Niño(a)

First NameLast Name
Address/Direccion

Street Address

Street Address Line 2

CityState

Zip Code
Cell or Home Number/Numero de Telefono

Area CodePhone Number
E-mail/Correo Electrónico
Childs Birth Date/Fecha de Nacimiento de su niño/niña

Month/MesDay/DiaYear/Año
Completed grade in school/Grado completado en la esuela
Childs Shirt Size- Talla de camisa del Niño/Niña
Please list any medical information we may need to know including allergies/Alergias o otras condiciones medicas
Emergency Contact Name/Contacto de Emergencia

First NameLast Name
Emergency Contact Number/Numero de Contacto de Emergencia

Area CodePhone Number
Who is allowed to pick up your child after dismissal each day? Quien mas tiene permiso de recoger a su hijo/hija?
How did you hear about this VBS? Como escucho de esta Escuelita Biblica?
May we take photos during VBS that might include your child? Tenemos permiso de tomar fotos durante Esuelita Biblica que pueda incluir a su hijo/hija?
Should be Empty:

VBS JUNIO 17-19 6:00PM to 8:00PM