VBS Pre-Registration Form


Childs Name (required)

Grade completed as of end of May 2018
 3-4 years K 1 2 3 4 5 6

Childs Age

Parents Name (required)

Physical Address (required)

Mailing Address (if different)

City, Zip

Cell Number

Phone Number

Is there any Medical/Allergy or Other Info we should know
 yes no

If so, please fill in here

Permission to photograph your Child during Bible School
 yes no

Permission to use your childs image or likeness for promotion
 yes no

Do you attend church?
 yes no

If so, Where?

Email Address

Parent Signature (by checking below you are certifying that you are the parent or legal guardian of the above child)