Student Information

Student's Name *

Gender *

MaleFemale

Age *

Class / Year this September *

Allergies (food or environmental) or other medical concerns we need to know *

T-Shirt Size *

Parent / Guardian

Parent/Guardian Name *

Relationship *

Phone *

Alternate Emergency Contact

Alternate Contact Name *

Alternate Contact Phone *

Consent

During the VBS week, photos and videos of all activities will be taken. The church may feature these footage in broadcast or print media, on the church website and Facebook page — permission for child to be photographed or filmed. *

YesNo

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Ministry of Jesus — VBS Registration Form

Student Information

Parent / Guardian

Alternate Emergency Contact

Consent