VBS Registration Form

Printable Registration Form

Parent/Guardian Contact Information









Zip

Emergency Contact Information

This information is the same as above.

(Only provide this information if it is different than the Parent/Guardian Information.)




VBS Student Arrival/Departure Information

Arrival: My student(s) will be brought by...

First Name Last Name

Departure: My student(s) will be picked up by...

This person will also pick up my student(s).

(Only provide this information if it is different than the one bringing the student(s).)

First Name Last Name

VBS Students You Want To Register

Please enter your child's first and last name and then select the appropriate age and grade (just finished) for each child.

Child 1
Child 2
Child 3
Child 4
Child 5
Child 6
Child 7
Child 8

Helpful Information

How did you hear about our VBS?
Repeat   Friend   Radio   Flier   Sign   TV   Newspaper  
Other  

Does your student attend a church regularly?
Yes   No           If yes, Name of Church

Does your student attend Sunday School regularly?
Yes   No

Permission and Medical Release Form

I (We) understand the nature of this event and permit our child to participate in the activities of this event at Bethel Baptist Church. I (We) grant permission for the necessary transportation of our child to locations associated with this event. I (We) understand that, in the event medical treatment is required, every effort will be made to contact me. However, if I cannot be reached, I give permission to the staff or sponsor to give first aid to my child and/or secure the service of a licensed physician to provide the care necessary, including anesthesia, for my child’s well being. I also understand that my insurance company or I will accept all medical expenses.

Parent/Legal Guardian Signature:

(By typing your name in the signature box, you are expressing your aggrement to the Permission and Medical Release form.)

Allergies/Medical Problems:

Comments or additional information

Please submit any comments or additional information you would like to share about your student here: