Register for VBS

Family Information

Address

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Dinner

Dinner 5:00-6:00 pm will be provided for the registered child and their parent(s). Other siblings are welcome for dinner too. Please be willing to stay with your child until 6:00pm.

Please let us know how many adults and children will be eating. Adults & Children Eating

Details

Weekdays

Student Information

Gender

Birth Date

Age Group

Food Allergies

Details

Medical Concerns

Details

Medical Release I give my permission for the VBS staff to administer basic first aid to myself (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me.

Photo Release I hereby grant the above named church permission to copyright and use photographs/videos taken at VBS of myself in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.

I have more students to register