| VBS 2011 Registration Form |
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Register me for
One form per child, please.Child's name ________________________ Grade Completed ____________________ Birthday _____________ Age __________Parents' names _____________________ Home address ______________________ Home Phone ________________________ Alternate Phone _____________________ Emergency Contact Person ____________ Relationship to student _______________ Home phone________________ Alternate phone _____________________________ Food allergies Y_______ N __________ List:____________________________________________________________ Medical concerns Y________ N ________ List: __________________________________________________________________ Family doctor _________________________________________ Doctor’s phone _________ Siblings attending VBS (names and ages) _________________________________________ Church affiliation _________________________________ Church membership at _______________________________ People who may pick up the child ________________________________________________________________ Transportation needed? Y______ N______ Attendance 1 2 3 4 5 |
