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VACATION BIBLE SCHOOL
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TEMPLE BAPTIST CHURCH
When and Where?
Event Timing: June 9th-12th, 2019 from 10:00am-1:00pm Event Address: 18841 SR31, North Fort Myers, FL 33917 Contact us at
childrenspastor@templenfm.org
or (239) 543-3222 Lunch will be provided! Children age 4 - 5th grade
Child 1 Name
*
Your answer
Child 1 Birthdate
*
MM
/
DD
/
YYYY
Child 1 Gender
*
Female
Male
Child 1 Last Grade Completed
*
Your answer
Child 1 Shirt Size
*
Choose
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Child 2 Name
Your answer
Child 2 Birthdate
MM
/
DD
/
YYYY
Child 2 Gender
Female
Male
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Child 2 Shirt Size
Choose
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Additional Children (Name, birthdate, gender, last grade completed, and shirt size)
Your answer
Parent/Guardian Names
*
Your answer
Home Address
*
Your answer
Home Phone
*
Your answer
Email
*
Your answer
Does your family currently attend church?
*
Yes
No
If yes, what church do you attend?
*
Your answer
Photo Release Permission
*
YES
NO
Required
Food Allergies (Please list child's name and allergies)
*
Your answer
Medical Needs/Concerns (Please list child's name and allergies)
*
Your answer
Emergency Contact Name
*
Your answer
Emergency Contact Phone
*
Your answer
Persons Authorized To Pickup Child From VBS
*
Your answer
Notes
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