Bellefounte Baptist Church - VBS Registration

VBS REGISTRATION FORM

Parent or Guardian Information

Parent/Guardian First Name

Parent/Guardian Last Name

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Email

Emergency Number

Phone Number

Does your child attend church? If so where?

May we have permission to photograph your child?

Yes

No

May we have permission to use your child's photograph for the purpose of promotion?

Yes

No

Child Information

Child First Name

Child Last Name

Birthdate

Grade Just Completed

Allergies (if none put N/A)

Tee Shirt Size

Pick Up Information

Please enter anyone authorized to pick up your child