Vbs Registration Form

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VBS Registration Form
Student’s Name ___________________________________________________________________________________
Parent/Family/Guardian Name _____________________________________________________________________
Address ___________________________________________________________________________________________________
_____________________________________________________________________________________________________
E-mail Address ___________________________________________________________________________________
Phone Numbers Home ______________________ Cell _____________________ Work____________________
Date of birth _______________________________ Age ________________________
Last school grade completed ______________________________________________
Home Church _____________________________________________________________________________________
Friends of your child at this church _________________________________________________________________
Allergies/Medical Information/Other
___________________________________________________________________________________________________
___________________________________________________________________________________________________
Emergency Contacts
Name _____________________________________________ Phone __________________________________
Name _____________________________________________ Phone __________________________________
Dismissal Information
Name(s) of person(s) who may pick up this child from VBS
__________________________________________________________________________________________________
Other Information (church use only)
Hero Group ____________________________________________________________________________________
Are parents/guardians/family members helping with VBS Hero Central? ___________
If yes, where? ____________________________________
If your child has Special Needs, please also fill out the form on the back!
Publicity & Registration

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