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VBS Pre-Registration Form

Info

    Childs Name (required)

    Grade completed as of end of May 2018
    3-4 yearsK123456

    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
    yesno

    If so, please fill in here

    Permission to photograph your Child during Bible School
    yesno

    Permission to use your childs image or likeness for promotion
    yesno

    Do you attend church?
    yesno

    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)