Emergency Contact (if parent/guardian cannot be reached) Name, Telephone, Relationship to Child *
Your answer
Allergies/Medical Needs (if none please put NONE) *
Your answer
Person(s) authorized for picking up this child at the end of the day: Name(s) and Telephone Number(s) *
Your answer
Anything special we need to know about your child?
Your answer
Shirt Size (indicate child/adult) *
Your answer
One friend my child would like to be with
Your answer
Special Needs classification & or circumstances
Your answer
We will be taking pictures during the week. We need your permission to take pictures of your child, put them on our PowerPoint Presentation for the final day, and our church website.
Clear selection
Signature (type) *
Your answer
Payment (Due at Registration) *
Would you be interested in volunteering for VBS?
Clear selection
A copy of your responses will be emailed to the address you provided.