2017 Vacation Bible School Registration
 
2017 Vacation Bible School Registration
Child’s Name  * 
Parent/Guardian Name  * 
Address (Street, City, Zip)
Mailing Address (if different)
PHONE NUMBERS
Home
Work
Mobile
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 CONTACTS (other than listed above)
Contact Name  * 
Contact Phone  * 
Contact Name
Contact Phone
DISMISSAL INFORMATION
Who may pick your child up at the end of each VBS day? * 
OTHER INFORMATION
Does your child attend church?  * 
If so, where?
If you child is visiting our church, who is he/she a guest of?
May we have permission to photograph your child for his/her craft project?  * 
May we have permission to use your child’s photograph for the VBS Family Night video to be shown to children and their families on Friday evening?  * 
May we have permission to use your child’s photograph on our child website? (Children will not be identified by name.)  * 
Your Email Address  * 
 
 
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