VBS Child Registration
Please list each child and age/grade for VBS during July 12-14, 2022.
Time: 6 PM - 8:30 PM
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Email *
Parent(s) Name *
Child #1 Name *
Child Age/Grade (recently completed grade) *
Child #2 Name
Child Age/Grade (recently completed grade)
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Child #3 Name
Child Age/Grade (recently completed grade)
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Child #4 Name
Child Age/Grade (recently completed grade)
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Child #5 Name
Child Age/Grade (recently completed grade)
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Emergency Contact 1 (name and number) *
Emergency Contact 2 (name and number) *
By signing this form, I give KSBC permission to take my child’s photograph/video while participating in church related events. These pictures/videos may be used in published materials by KSBC (bulletin boards, brochures, booklets, website publications and any other form of publication). I also acknowledge that the child listed above, nor anyone affiliated with the child, may receive compensation for the use of the child’s photograph/video. Printed name serves as signature. *
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