St. Paul’s Bible Church
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2011 VBS REGISTRATION FORM
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
*
Home Phone #
*
-
-
Work Phone #
*
-
-
Cell Phone #
*
-
-
Child's Age
*
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?
*
Do you attend Sunday School? If so where?
*
If you are visiting our church, who are you a guest of?
*
May we have permission to photograph your child?
*
Yes
No
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