Child Information
Child's Name (First & Last)
Birthday (MM/DD/YYYY)
Grade (Last Completed) ---4-K5-K123456
Medical Information (Include food allergies)
Parent Information
Parent Name (First & Last)
Address
City
State
Zip
Mailing Address (If Different from Address)
Home Phone
Work Phone
Cell Phone
Email
Emergency Contacts
Name (First & Last)
Phone Number
Dismissal Information
Who may pick up your child at the end of each VBS day?
Other Information
Does your child attend Sunday School? If yes, where? ---YesNo
If your child is visiting our church, who is he/she a guest of?
May we have permission to photograph your child? ---YesNo
May we have permission to use your child's photograph for the purpose of promotion? ---YesNo
