Vacation Bible School 2017 Registration

Child's Name*

Parent/Guardian Name*

Address*

Mailing Address (if different from above)

Home Phone*

Work Phone*

Cell Phone*

Parent Email*

Child's Birth Date*

Last Grade Completed in School*

Medical Information (or other information we need to know, please include food allergies)*

Emergency Contact*

Emergency Contact*

Other Information*
Does your child attend Sunday School? If so, where?

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