VBS 2010 Registration

Complete the form below to signup for Vacation Bible School 2010. If you are registering more than one child, each child will need to be registered individually.

Child's Name:
Parent/Guardian Name:
Address:
Mailing Address (if different):
Phone Numbers
Home:
Work:
Cell:
E-mail Address:
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 Contacts
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 photo for the purpose of promotion? Yes No