Wufoo

Faith Community Church - VBS Signup

July 13 - 17, 2009
9:00 AM-Noon
Open to children who will be in K - 6th grade in the 2009 - 2010 school year.

Please complete one form per child.

Child's Information
Child's Name * First Last
Grade for 2009 - 2010 school year
(Note: sorry, there are no preschool classes) *

Due to safety concerns we are unable to offer preschool classes this year, except for VBS Volunteers' children.
Date of Birth * MM / DD / YYYY
Any allergies or medical conditions we would NEED to know of?

If your child has food allergies, please bring a snack for your child each day in a bag marked with her/his name and give it to the group leader.
Parental Information
Parent or Guardian's Name * First Last
Primary Phone * ### - ### - ####
Secondary Phone ### - ### - ####
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Email *
Second Adult Authorized to Pickup Child (if applicable) First Last
Third Adult Authorized to Pickup Child (if applicable) First Last
Anyone UNAUTHORIZED to pick up your child? First Last
Additional Comments:
Agreement

Submission of this registration form implies permission to photograph or videotape your child as he/she participates in VBS. Images will be used in promotion of Faith Community Church's VBS only.
Do Not Fill This Out