VBS SIGNUP FORM

Mark your calendars for Vacation Bible School!
June 2nd - 5th from 9am -12pm

Parent's Contact Information:

Parent's First Name

Parent's Last Name

Parent Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Emergency Contact:

(In Case Parent is Unavailable)

First Name

Last Name

Phone Number

Child Information:

First Name

Last Name

Grade Level Going Into:

Any Food Allergies:

Additional Information:

Will you be inviting a friend? ... List their names here:

Please list any other person (s) authorized to take child from premises:

Will you allow your child to be dismissed from VBS without a parent or guardian present?

As the parent / guardian, I GRANT PERMISSION for my child to walk / bike home.

I DO NOT grant permission for my child to walk / bike home.

Photography Consent:

As the parent / guardian, I understand that my child(ren) may be photographed or video recorded during normal VBS activities. I understand that these images or videos may be used in promoting VBS, either in print or on the internet.

Any Special Information:

VBS SIGNUP FORM

Parent's Contact Information:

Emergency Contact:

Child Information:

Additional Information:

Service Times

Contact Info

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