CT B.I.T Vacation Bible School 2020
Registration Form
Student's Name
*
First Name
Last Name
Age of student?
What grade will student be entering Fall 2020?
*
Are you affiliated with a church? If so, which?
(1) Parent/Guardian Name
*
First Name
Last Name
(1) Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(1) Parent/Guardian Email
*
example@example.com
(1) Parent/Guardian (Best) Phone Number
*
-
Area Code
Phone Number
(2) Parent/Guardian Name
First Name
Last Name
(2) Parent/Guardian Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
(2) Parent/Guardian Email
example@example.com
(2) Parent/Guardian (Best) Phone Number
-
Area Code
Phone Number
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
-
Area Code
Phone Number
Physician's Name
*
First Name
Last Name
Physician's Phone Number
*
-
Area Code
Phone Number
Does your student have any allergies? If so, what?
*
Any other health concerns B.I.T leaders should be made aware of?
Is there anything we need to know about working with your student that will help us set them up for success and thrive in this program?
Permission to use photos of student from camp for promotional materials? (This will include a slideshow from camp that will be sent to parents)
*
Yes
No
Submit
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