Harvard Bible Church (HBC) Vacation Bible School (VBS) Registration Form

Harvard Bible Church (HBC) Vacation Bible School (VBS) Registration Form
Register for Operation Arctic!

Please fill out one form per child. If registering more

than one child, only fill out top section plus parent/

guardian name and phone number for additional

children.
Child's Info
Child's Name*
Child's gender*

malefemale
Date of birth *
Grade completed*
Food allergies*

YesNo
Please list the allergies hear along with any concerns that relate to the allergy/allergies
PERMISSION TO USE IMAGES AND VIDEO Comments or stipulations below in the box*
We plan to take photos of campers for use in a slideshow. Photos may also appear onHarvard Bible Church’s Facebook page. If you are not comfortable with the use of yourchild’s image in this way, please let us know below. Otherwise, by participating in thecamp, we assume that you grant permission for Harvard Bible Church to record and usesounds, images, or video of my child (Named Above) while attending this VBS program.
Parent/guardian signature *

Clear
Parent Information
Parent's Name *

First NameLast Name
Parent's Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Name of home church (if applicable)
Alternate Emergency Contact Name*
Alternate Emergency Contact*
Please enter a valid phone number.
Relation the the child*
Can anyone else pickup your kid?*
Should be Empty:

Child's Info