VBS Registration Child's Name* First Last 2nd Child's Name First Last Parent/Guardian Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Contact InformationHome PhoneCell PhoneEmail Age Information (for each child)First Child's Birth Date* MM slash DD slash YYYY First Child's Last Grade Completed Fist Child's Medical InformationMedical or other information we need to know. (Please include any food allergies.)Second Child's Birth Date MM slash DD slash YYYY Second Child's Last Grade Completed Second Child's Medical InformationMedical or other information we need to know. (Please include any food allergies.)Emergency Contacts (other than listed above)Dismissal InformationWho may pick up your child at the end of each VBS day?Other InformationDoes your child(ren) attend Sunday School? If so where? If your child is visiting our church, who is he a guest of? May we have permission to photograph your child(ren)? Yes No May we have permission to use your child(ren)’s photograph for the purpose of promotion? Yes No CAPTCHANameThis field is for validation purposes and should be left unchanged.