Form

Address

Mailing Address if different

Mailing Address (if Different)
Home Number
Work Number
Cell Number
E-mail
Age information
Child's Birth Date
Month Day Year
Last Grade Completed
Medical information
( Medical or other information we need to know . Please include allergies)
Emergancy Contact
Emergency Contact
Phone Number
2nd Emergeny Contact
Phone Number
Dismissal information
Who may pich up your child at the end of each VBS day
Other information
Do you attend sunday school? If so where?
If you are visiting our church, who are you a guest of?
May we gave permission to photograph your child?
May we have permission to use your chil's photograph in church publications for the purpose of promotion?
Should be Empty:

Age information