Vacation Bible School Registration Form

Child's Name

Child's Age

Child's last grade completed

VPK Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade

Parent/Guardian Name

Parent/Guardian's Cell Phone

Mailing Address

Parent/Guardian's Email

This address will receive a confirmation email

Emergency Contact Name

Emergency Contact Phone Number

Name(s) of individuals who are allowed to pick up my child from VBS

Does your child have any special needs? If yes, please give us more information.

Does your child have any allergies? If so please list the allergen and severity and treatment.

Please list any medical information about your child that would be important for us to know.

Is there anything else you would like us to know about your child?

Photo Release

Yes, I give my permission to let Highlands United Presbyterian Church use my child's photo in print publications, online publications and social media posts for Highlands United Presbyterian Church. No, I do not give my permission to let Highlands United Presbyterian Church use my child's photo in print publications, online publications or social media posts for Highlands United Presbyterian Church.

Description

Please fill out this form and click submit. You will need to complete one form for each child that will be attending VBS.

Vacation Bible School Registration Form

Description

Please Fix the Following