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La Plata Baptist Church VBS Registration Form
Please fill out a SEPARATE form for EACH child attending. THANK YOU
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* Indicates required question
Child's Name
*
Your answer
Age
*
Your answer
Grade last completed(Spring 2020)
*
Age 3-Pre K
K
1st
2nd
3rd
4th
5th
6th
Mailing Address
*
Your answer
Phone Number
*
Your answer
Email address
Your answer
Emergency Contact(s) (name and phone number)
*
Your answer
Allergies/Medical Concerns (Please type N/A if does not apply to your child)
*
Your answer
May we have permission to photograph your child?
Yes
No
Clear selection
May we have permission to use your child's photograph in church publications for the purpose of promotion?
Yes
No
Clear selection
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