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Vacation Bible School Registration Form 2021
"Rocky Railway" Jesus' Power Pulls Us Through
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* Indicates required question
Please see Tabatha Nantz with questions. COVID precautions will be taken to protect your child!
Child’s Name
*
Your answer
Mailing Address
*
Your answer
Grade COMPLETED this year:
*
5th grade
4th grade
3rd grade
2nd grade
1st grade
Kindergarten
Pre-K 4 years old
Pre-K 3 years old
Required
Parent(s) Name (first and last)
*
Your answer
Cell Number or Best Number to Call during VBS
*
Your answer
Emergency Contact Other than Parent (Name)
*
Your answer
Emergency Contact's Phone Number
*
Your answer
Please list any medical information we may need to know about your child. Be specific. (Examples: diabetes, asthma, ADHD)
*
Your answer
Please list any medications your child is currently taking.
*
Your answer
Please list any food allergies or other allergies your child may have.
*
Your answer
Do we have permission to take your child's picture and possibly post on our website and/or our church Facebook page?
*
Yes,
No
Is there anything else we need to know about your child?
Your answer
Church Information:
*
I am a member of BDBC.
We are members of another church.
We do NOT currently have a church home.
Required
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