Vacation Bible School child registration form Must be at least 4 years old by june 10th Child's Name * First Name Last Name Parent/Guardian Name * First Name Last Name Address * (street address, city, state, and zip code) Phone * (###) ### #### Email * Age imformation 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) Emergency Contact 1 * First Name Last Name Phone * (###) ### #### Emergency Contact 2 * First Name Last Name Phone * (###) ### #### Dismissal Information * Who may pick up your child at the end of each VBS day? Other information Does your child attend church? 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 And if your child has a friend in the same age/grade that they would like to be paired with please list their full name Thank you!
