Vacation Bible School Online Registration

VBS Offline Registration Form Download

VBS Online Registration

Student Information

Student's first name *

Student's last name *

Age *

Nickname

Grade the student is entering *

What days will your child be attending?

MondayTuesdayWednesdayThursdayFriday

Medical Information

Allergies

Please list any allergies your child has, each on its own line.

Medical issues or special needs

Please be descriptive.

Parent/Guardian Information

First name *

Last name *

Primary phone *

Email *

Address

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

General information

Let us know anything that you think we should know that wasn't included in this form.

Emergency Contact

Name *

Phone *

Alternate Pickup

The following people can pickup your child if you are not available:

Name *

Phone *

Name

Phone

Name

Phone

Church Information

Home church (If applicable)

Special Considerations

It would be nice if my child were in the same group as:

Permissions

Check all that apply:

Medical Release: I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me.Photo Release: I hereby grant the above named church permission to copyright and use photographs/videos taken at VBS of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.Permission to Attend: I give permission for my child (named above) to attend the Vacation Bible School (VBS) listed above. I understand that the information I give for this registration will only be used by the VBS hosting church, and that all registration information will be removed from the hosting site by December 31 of this year.

Verification

Please enter any two digits *Example: 12
This box is for spam protection - <strong>please leave it blank</strong>:

The Good Shepherd's Little Lambs Preschool