Registration Form
Child’s Name _________________________________________________________
_________________________________________________________ Parent/Guardian Name _____________________________________________
_____________________________________________
Address _ _____________________________________________________________
_ _____________________________________________________________ Phone Numbers:
Home _____________Work _______________Cell ______________
E–mail: ________________________________________________________________
________________________________________________________________ Age Information:
Birth date (for preschoolers) or last grade completed in school
____________
Medical Information:
Medical or other information we need to know. (Please include any
food allergies.)
________________________________________________________________________
________________________________________________________________________
_______________________________________________________
Emergency Contact:
Name_________________________ Phone number________________
Name_________________________
Phone number ________________
Dismissal Information:
Who may pick 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 have permission to photograph your child? Yes No
May
we have permission to use your child’s photograph in church
publications for
the purpose of promotion? Yes No
T-shirt size ________________
©2007, LifeWay Christian Resources of the Southern Baptist Convention,
VBS 2008, Published in the United States of America
