Vacation Bible School - Calvary Baptist Church

Vacation Bible School Registration Form:
Pre-K thru 6th grade
Monday, 6/25 – Friday, 6/29 from 6:30pm to 8:30pm each day.

Child's Name *

First

Last

If you are registering more than one child, please submit a separate form for each child.

Child's Birth Date: *

MM/DD/YYYY

Child's Completed Grade: *

Mother's/Guardian’s Name & Phone Number during VBS: *

Father’s/Guardian’s Name & Phone Number during VBS: *

Home Address: *

City, State & Zip Code: *

Primary Phone Number: *

xxx-xxx-xxxx

Parent/Guardian's Email Address: *

Confirm Email

Home church (if any)

Doctor's Name & Phone Number: *

Allergies/Medical Issues/Special Instructions:

Person(s) authorized to pick up child: *

Emergency contact if parent/guardian can’t be reached: *

Terms and Conditions of Registration Submission: *

I understand by submitting this registration form; I give my permission to the staff to seek medical attention for my child if necessary while participating in the VBS program. I understand that all necessary precautions will be taken for my child’s safety. I will not hold the church, its staff, or those supervising liable. I give permission for my child to be photographed or videotaped for any lawful purpose associated with this VBS.

Today's Date: *

MM/DD/YYYY