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2019 VBS REGISTRATION FORM
*
Indicates required field
Child’s Name
*
First
Last
(list additional children’s at the bottom of this form)
Parent/Guardian Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Email
*
Cell Phone #
*
Home Phone #
*
Child's Age
*
Work Phone #
*
Medical information we need to know (please include any food allergies)
*
Medical or other information we need to know. (Please include any food allergies)
Emergency Contact (name and number)
*
Name and phone number
Emergency Contact #2 (name and number)
*
Name and phone number
Who may pick up your child at the end of each VBS day?
*
How did you hear about VBS?
*
Do you attend church? If so where?
*
Register A 2nd Child (name, age, medical information)
*
Name, Age and Medical Information
Register A 3rd Child (name, age, medical information)
*
Name, Age and Medical Information
Register A 4th Child (name, age, medical information)
*
Name, Age and Medical Information
Register A 5th Child (name, age, medical information)
*
Name, Age and Medical Information
Medical & Media Release:
By submitting this registration form I release St. Paul’s Bible Church, its staff, employees, officers and volunteers, from any and all liability in the event of injury or incident while participating in VBS. I give the staff and volunteers at St. Paul's Bible Church permission to seek medical treatment for my child in the event of an emergency when I cannot be reached. I also agree to allow St. Paul's Bible Church to use my child's photo (without name) in their public media, including the website.
Medical & Media Release
*
I Agree
Submit
Home
I'm New
Times and Directions
What To Expect
About Us
What We Believe
Vision And Values
Staff
Missionaries
History
Ministries
Children
Adults
Youth
Care & Serve
VBS
Messages
Who Is God?
Miracles
Blast From The Past
General
Events
GIVE