VBS Registration

VBS REGISTRATION FORM 2022

* Indicates required field

Student Name *

First

Last

Parent/Family/Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Date of Birth *

Age *

Last school grade completed *

Home Church (if any) *

Friends of your child at this church *

Special Needs/Allergies/Medical Information/Other *

Emergency Contact 1 *

First

Last

Phone *

Emergency Contact 2 *

First

Last

Phone *

Name(s) of person(s) who may pick up this child from VBS *

Photo Release:

Grace Calvary Chapel Church/VBS has my permission to use my child's photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Parent Signature *

First

Last

Date *

Submit

VBS REGISTRATION FORM 2022

Photo Release:

We Would Love to Have You Visit Soon!