VBS Registration Form
Child's Name
First Name
Last Name
Parent/ Guardian Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone Number
-
Area Code
Phone Number
Work Number
-
Area Code
Phone Number
Cell Phone
-
Area Code
Phone Number
Email
example@example.com
Age Information
Birth Date
Last grade completed in school
Medical information
Medical or other information we need to know. (Please include any food allergies)
Emergency Contact (Other than listed above)
Name and Phone Number
Dismissal Information
Who may pick up your child at the end of each VBS day?
Other Information
Does your child attend Sunday School? If so where?
If your child is visiting our church, who is he a guest of?
May we have permission to photograph your child?
Yes
No
May we have permission to use your child's photograph for the purpose of promotion?
Yes
No
Submit
Should be Empty: