EmailMe Form - 2020 VBS Registration

Child's Name *

First Last

Parent/Guardian Name *

First Last

Phone *

### - ### - ####

Best phone number to contact you during the event.

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Email *

parent/guardian email address

Birth Date *

MM / DD / YYYY

Last Grade Completed in School *

Medical Information *

Medical or other information we need to know. (Please include any allergies)

Emergency Contacts *

Other than those listed above.
Please include NAMES & PHONE NUMBERS

Dismissal Information *

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

Church Home

Permission to Photograph your Child *

YES

NO

Permission to Use your Child's Photo for Promotion? *

YES

NO

How did you hear about our VBS?