Register for VBS

Family Information

In case of emergency, Parent/Guardian will be contacted first. Please include Parent/Guardian phone number and email.

Address

Parent / Guardian Information

Primary Phone

Alternate Phone

Parent/Guardian 2 Phone Number

Emergency Contact's Information

Please put someone other than the Parent/Guardian listed for the Emergency Contact. In case of emergency, Parent/Guardian will still be contacted first.

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Permissions

Who can pick up your child?

I hereby give permission for the caretakers involved in the WRBC children’s ministry to care for my child while he/she participates in VBS. In the event of a medical emergency, the parent/guardian(s) mentioned above will be contacted. WRBC children’s ministry caretakers will take appropriate medical action until a parent/guardian arrives. Permission

Photo Permission

I grant permission for my child’s photo to be taken and may appear among general church photos (ie. church website, facebook, & additional publications) as long as there is no identifying information shown.

Student Information

Please select the grade entering this fall.

Gender

Birth Date

Age Group

Food Allergies

Details

Medical Concerns

Details

I have more students to register