VBS Registration 2024 – First Baptist Church

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Name *

First

Last

Address (Street, City, State, Zip Code) *

Grade Going Into *

Age *

Birth Date *

Allergies/Medical Information *

Parent/Gurdian Name *

First

Last

Phone Number *

Email *

Emergency Contact Name (other than parent) *

Emergency Contact Phone Number *

Brought By (Van or Parent Pick-up) Van runs inside city limits only *

Authorized Pickup Person(s) *

Home Church

May we have permission to photograph your child? *

May we have permission to use your child's photograph in church publications/social media posts? *

Additional Information (not required)