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ROAR! VBS Registration Calvary Baptist Church
Use this form to register your child for ROAR! VBS at Calvary Baptist Church Floyd, VA. Please fill out one form for each child you are registering. Thank you!
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* Indicates required question
Child's Name
*
Your answer
Child's gender
*
Female
Male
Child's age
*
Your answer
Child's date of birth
*
MM
/
DD
/
YYYY
Last school grade completed
Your answer
Name of parent(s)/guardian(s)
*
Your answer
Street address
*
Your answer
City, State Zip
*
Your answer
Home telephone with area code
*
Your answer
Parent/Guardian's cellphone with area code
*
Your answer
Email address
*
Your answer
Home church
Your answer
Who is picking your child up, if not you?
Your answer
Allergies or other medical conditions
Your answer
In case of emergency, contact: (name, phone, relationship to child)
*
Your answer
Do you agree to allow photos of your child to be used in church presentation or church promotional materials?
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Yes
No
Medical Release: I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me. Please type your name to consent.
*
Your answer
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