VBS Child Registration Form - St. John's Episcopal Church

VBS 2018 Logo

Montgomery Convocation of Episcopal Churches presents…

June 4-7, 8:30 – Noon
Church of the Ascension
Rising K4 – Rising 6th Grade

COMPLETE ONE FORM PER CHILD
Pre-Reservation Deadline May 21, 2018
Name*
First Last
Name Child Goes By*
Age*
Date of Birth*
MM
DD
YYYY
Grade in 2018-2019*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Parents' Names*
Email Address*
Home Phone*
Work Phone
Cell Phone
Please indicate which number we should call you during the VBS hours*
- Home Phone
- Work Phone
- Cell Phone
Special Needs or Medical Conditions
Allergies or Food Restrictions
Home Parish*
I give my permission in the event of an emergency to seek medical treatment for my child.*
- Yes, I give permission
- No, I do not give permission
I give my permission for the church to use pictures of my child on their website and social media for informational or promotional purposes.*
- Yes, I give permission
- No, I do not give permission