VBS Participant registration

child parent/guardian, your

Participant Name *

First

Last

Gender *

Date of Birth *

mm/dd/yyyy

Last grade completed in school *

Allergies

Medical concerns

Comments

Parent/Guardian Name *

First

Last

Email *

Mailing Address *

Phone *

Emergency Contact Name *

Relationship *

Phone *

Other than parent/guardian, who may pick up your child at the end of the VBS day? *

Relationship *

Does your child attend church?

If so, where?

If your child is visiting our church, who invited them?

May we have permission to photograph your child? *

i.e. Arts & Crafts

May we have permission to use your child's photograph for the purpose of promotion? *

i.e. Worship rally video