Game On VBS Registration

Vacation Bible School will be held from June 12th through June 16th from 5:30 PM - 8:15 PM with commencement on June 17th at 5:30 PM.

Child's Name*
Parent/Guardian Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Work Phone
Cell Phone
Email
Age of Child*
Last Grade Completed in School
Emergency Contact and Medical issue/Allergies*
Please list emergency contact person(s) and phone numbers, if different form above. List any medical allergies
Dismissal Information*
Who may pick up your child at the end of each VBS day?
Other Information
Does Your child attend Sunday School? if so where?
Photography Waiver*
May we have permission to photograph your child? Please write yes or no. If so can we use your child's photograph for the purpose of promotion? Please write yes or no.