VBS Registration Form Child's Name * First Name Last Name Parent/Guardian Name * First Name Last Name Address Home Address Address 1 Address 2 City State/Province Zip/Postal Code Country Contact Information Home Cell Number * (###) ### #### Work Cell Number * (###) ### #### Email Address * Child's Age Information Birthdate * MM DD YYYY Last Completed Grade in School Group Preference, VBS Buddies (MUST BE SAME GRADE) My child would like to attend with (other students names) Medical Information Medical or other information we need to know. (Please include any food allergies) Emergency Contacts (other than listed above) Names & Phone Numbers 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? I understand that my child may be photographed at this event, and that these photographs may be used in internal promotional material for this event. * Thank you!
