Vacation Bible School Registration (For Grades 1-6) 2021

General Information

Student's Name

Parent/Family/Guardian Name

Address

This address will receive a confirmation email

Home Phone

Cell Phone

Work Phone

Child's Birthdate

Child's Age

Last Grade of School Completed

Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6

Home Church (if any)

Friends of your Child at this Church

Special Needs/Allergies/Medical Information/Other Info we Need to Know about your Child

Info to Protect Your Child

Contact #1: First and Last Name

Contact #1: Phone Number

Contact #2: First and Last Name

Contact #2: Phone Number

Name(s) of person(s) who may pick up this child from VBS

Photo Release By checking this box I give Gospel Centre Church permission to use my child's photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understan

Parent/Guardian's Signature

Date

Description

Please fill out this form and click submit.

Vacation Bible School Registration (For Grades 1-6) 2021

Description

Please Fix the Following