VBS Registration

Posted on June 11, 2019 by execadmin

Child's Name *

Child's Gender *

• Female
• Male

Child's Age *

Date of Birth *

Last Grade Completed *

Name of parent(s)/guardian *

Street Address *

City *

State *

ZIP *

Email *

Primary Phone *

Cell Phone

Home Church

Allergies or other medical conditions that we should know about

In case of emergency, contact: *

Emergency Contact Phone *

Emergency contact's relationship to child *

IMPORTANT: Please check one of the boxes below regarding your child having their photograph taken. Throughout the week, VBS crew members will be taking pictures of children to put together a picture slide show for the last night of VBS. The slide show will also be shown to the church congregation the following Sunday during worship. No pictures will be posted on any social media platform. You MUST check one of these options: *

• Yes, I give consent for my childto have his/her photo taken and presented in a slide show for the las day of VBS and for the congregation to view.
• No, I do not give consent for my child to have his/her photo taken.

Email

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