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Knox VBS 2019- To Mars and Beyond
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Participant's Last Name
*
Your answer
Participant's First Name
*
Your answer
Birth Date
*
MM
/
DD
/
YYYY
Grade they will be entering September 2019
*
JK
SK
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Please list any special learning needs, allergies, or medical needs the VBS staff should be aware of to better help this child.
Your answer
Name of parent/guardian
*
Your answer
Parent/Guardian Phone Number (s)
*
Your answer
Parent/Guardian email (Needed to receive confirmation email)
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Phone number (If parent/guardian can't be reached)
*
Your answer
Do we have permission to take photos/video of your child for VBS related projects that may be posted on the Church Website?
*
Yes
No
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