V.B.S. Registration Form 
                                                           (Please copy and print this form to bring to registration)
Child’s Name: __________________________________________________________________________________
Child’s Age and Grade completed (if apply): __________________________________________________
Parent/Guardian Name  ________________________________________________________________________
-Phone_________________________________________________________________________________________________
-Address: ________________________________________________________________________________________

Medical Information/Other Information (Food or any allergies, etc): _______________________________________________________________________________________________________________________________________________________________________________________________________
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Emergency Contact: ___________________________________________________________________________________________________
 
Who may pick up the student at dismissal if other than names listed above? ___________________________________________________________________________________________________
Other Information:
Do you attend Sunday School? If so where? ____________________________________________________
If you are visiting, would you like more information about our church? Yes_____ No______
May we have permission to take a photograph of your child? Yes___ No____    
If yes, can we use the photograph in church publication (like our webpage for purpose of            promotion)?  Yes____No____