VBS 2019

Address: *

Date of Birth (Must be 3yrs old as of Sept. 1, 2018): *

Email:

Secondary Phone: *

If yes, what church does he/she attend?

Parent/Guardian Name: *

Does your child need transportation to VBS? *

Yes

Does your child attend Sunday School?

Yes

Occasionally

Primary Phone: *

Child's Name: *

Last Grade Completed: *

May we have permission to photograph your child for the Celebration Day video for parents/family? *

Yes

Person(s) authorized to pick up child after VBS (Name and Phone): *

Medical Information *

Emergency Contact (Name and Phone): *

Emergency Contact (Name and Phone):