VBS Pre-Registration

PRE-REGISTRATION FORM

June 22nd - 26th

Fork Baptist VBS

* Indicates required field

Student Name *

First

Last

Parent/Family/Guardian Name *

Address *

Email *

Cell Phone *

Work Phone *

Date of Birth *

Age *

Last school grade completed *

Home Church (if any) *

Friends of your child at this church *

Special Needs/Allergies/Medical Information/Other *

Emergency Contact 1 *

First

Last

Emergency Contact 1 Phone *

Emergency Contact 2 *

First

Last

Emergency Contact 2 Phone *

Photo Release: Church/VBS has my 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 understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Photo Release Consent *

I consent to the Photo Release I do not consent to the Photo Release

Type Parent or Guardian Signature *

Date of Form Completion *

Submit