Vacation Bible School Registration Form

Child #1 (Name and Age)

Child #2 (Name and Age)

Child #3 (Name and Age)

Child #4 (Name and Age)

Parent's/Guardian's Name

Address

Phone (Cell)

Phone (Home/Work)

Medical Information: Please share any medical or other information we need to know. Please include any food allergies, EpiPen, etc.

Emergency Contact #1: Name and Number

Emergency Contact #2: Name and Number

Pickup Information: Who may pick up your child at the end of the VBS day?

Other Information: Do you have a church family? If so, where?

Other Information: If you are a visitor of our church, how did you hear about our VBS Program?

May we have permission to photograph your child?

Yes

May we have permission to use your child's photograph in church publications for the purpose of promotion?

Yes

My child/children will attend:

Week 1

Week 2

Entire Event

Registration Fee

$50/week

$100/week

Registration payments can be submitted via Zelle, CashApp, or PayPal. Which will you use?