VBS Child Registration Form Montgomery Convocation of Episcopal Churches presents… Wilderness Escape VBS June 7-10, 8:30- 11:30 am Rising K4- Rising 6th Grade COMPLETE ONE FORM PER CHILD Pre-registration Deadline May 24, 2021Name* First Last Name Child Goes By*Age*Date of Birth* MM DD YYYY Grade in 2021-2022*K4K51st Grade2nd Grade3rd Grade4th Grade5th Grade6th GradeAddress* Street Address City State / Province / Region ZIP / Postal Code Parents' Names*Email Address* Home Phone*Work PhoneCell PhonePlease indicate which number we should call you during the VBS hours*Home PhoneWork PhoneCell PhoneSpecial Needs or Medical ConditionsAllergies or Food RestrictionsHome Parish*I give my permission in the event of an emergency to seek medical treatment for my child.*Yes, I give permissionNo, I do not give permissionI 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 permissionNo, I do not give permissionHow would you prefer your child participate in VBS?*In-person VBSVirtual VBS