VBS Registration

Child Name

Parent/Guardian Name

Address

Mailing address(if different)

Home Phone Number

Work Phone Number

Cell Phone Number

Child Birth Date

Child Last Completed Grade

Medical Information(allergies, etc. if needed)

Emergency contact 1 name

Emergency contact 1 phone

Emergency contact 2 name

Emergency contact 2 phone

Dismissal Information(Who will pick up your child?)

Have you attended Sunday School? If so, where?

If you are visiting our church, who are you a guest of?

May we photograph your child?(type yes or no)

May we photograph your child for our VBS promotions? (type yes or no)