Vacation Bible School

VBS 2015

June 14-19

6:00pm

 

 

Registration Form

Child’s Name ____________________________________________

Parent/Guardian Name ___________________________________

Address

 

 

_ _____________________________________________________________ _ _____________________________________

Phone Numbers:

Home _____________Work _______________Cell ______________

E–mail:

________________________________________________________________

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 Contact:

Name_________________________ Phone number________________

Name_________________________ Phone number ________________

Dismissal Information:

Who may pick up your child at the end of each VBS day?

________________________________________________________________________

Other Information:

Do you attend Sunday School? If so where?

________________________________________________________________________

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

________________________________________________________________________

May we have permission to photograph your child? Yes No

May we have permission to use your child’s photograph in church

publications for the purpose of promotion? Yes No

 

 

Mailing Address (if different)

 

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