VACATION BIBLE SCHOOL
ONLINE REGISTRATION

VBS at WFBC: JUNE 1-5
6:15 - 9:15 p.m.

If you have any questions then give us a call or fill out this form, and we will get back to you as soon as possible. We would love to hear from you!

* = Required Field

Child's Name*
Parents'/Guardians' Name*
Address*
City*
Zip Code*
Home Phone*
Cell Phone
Work Phone
Email Address
Birth Date or Last Grade Completed in School*
Medical Information* Medical or other information we need to know (Please include any food allergies). Enter "none" if there is no medical or other information we need to know
Emergency Contact 1 Name*
Emergency Contact 1 Phone Number*
Emergency Contact 2 Name
Emergency Contact 2 Phone Number
Who may pick up your child at the end of the day?*
Other Information:
Do you attend Sunday School?	yes no
If yes, where?
May we have permission to photograph your child?	yes no
May we have permission to use your child's photograph in church publications?	yes no
Special Needs Information
Is your child verbal? Describe if necessary.
Does your child need assistance with walking? Describe if necessary.
Does your child need assistance with toileting? Describe if necessary.
Does your child need assistance with eating? Describe if necessary.
Is your child able to play outside? List special precautions if necessary.
What activities does your child enjoy?
What are your child's food preferences?
List any allergies.
How can we best comfort your child when he/she is upset?
Special concerns for your child while in VBS?
Does your child have friends who are attending VBS? If yes, what are their names?