Vacation Bible School

Student 1

Student Name:

Student Age:

Birth Date:

Student 2

Student Name:

Student Age:

Birth Date:

Student 3

Student Name:

Student Age:

Birth Date:

Student 4

Student Name:

Student Age:

Birth Date:

Emergency Information

Contact 1:
Phone Number:

Contact 2:
Phone Number:

Does your child have any allergies or medical concerns?

Who will be bringing your child to VBS?

Who can pick up your child from VBS?

May we take photographs of your child to be used in the closing service?
Yes
No

Is there anything else you would like us to know?