Arbor Baptist Church / Vbs / Vbs Registration

Register for our VBS event by filling out the information below:

CHILD'S FIRST and LAST NAME:

DOB: (date/ month / year)

LAST GRADE COMPLETED:

ADDRESS:

CITY:

STATE:

ZIPCODE:

Parent / Guardian Information

NAME:

EMAIL ADDRESS:

PHONE NUMBER:

NAME:

EMAIL ADDRESS:

PHONE NUMBER:

Incase of an emergency, are the phone numbers above the best way to reach you?

YES

NO

If no, what is an emergency contact phone number for you?

Emergency Contact

You must provide two emergency contacts other than yourself.

NAME:

PHONE NUMBER:

RELATIONSHIP TO CHILD:

NAME:

PHONE NUMBER:

RELATIONSHIP TO CHILD:

In the event of an emergency and we can't reach anyone by phone, where will you be during the hours of VBS?

MEDICAL INFORMATION Please list ANY medical information we need to know, including food allergies.

Is there any other information unique to your child we need to know?

DISMISSAL / PICK UP Your child will only be released to the persons listed below. Photo ID will be required. Other than the parent / guardian(s) listed above, who may pick up your child? NAME:

RELATIONSHIP TOCHILD:

NAME:

RELATIONSHIP TO CHILD:

NAME:

RELATIONSHIP:

SPIRITUAL INFORMATION:

To my knowledge, my child has not received Jesus as Savior and Lord.

To my knowledge, my child has already received Jesus as Savior and Lord.

To my knowledge, my child has received Jesus as Savior and lord but has not been baptized.

Does your family currently attend or are members of a local church?

Yes

No

PHOTO / SOCIAL MEDIA RELEASE: Images published by Arbor Baptist Church will not identify any minor child by name.

Arbor Baptist Church may take photographs of my child during VBS.

Arbor Baptist Church may publish photographs of my child on the church website, Facebook, Twitter, Instagram and other social media sites.

Arbor Baptist Church may publish photographs of my child in church sponsored media not associated with the internet.

By writing my name below I am admitting I am of legal age and have the authority to register this child for Vacation Bible School.

VBS Registration