Wild Life VBS Registration | July 30 - August 2, 2023

Child's Name *

Parent/Guardian Name *

Address *

Mailing Address (if different)

Contact Info

Home Phone

Work Phone

Cell Phone *

Emergency Contact 1 *

Emergency Contact 2 *

Email Address

Birth Date *

Last grade completed in school? *

Medical or other information we need to know. (Please include any food allergies.)

Who may pick up your child at the end of each VBS day? *

Does your child attend Sunday School? If so where? *

If your child is visiting our church, who are they a guest of?

May we have permission to photograph your child? *

Yes

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

Yes