Outrigger Island:
Living God's Unshakable Truth
VBS Enrollment Card

Child's Name:*

Parent/Guardian:*

Address:*

City:*             State:*     ZipCode:*
           

Phone Numbers:

Home:*
Work:
Cell:

Email:

Age Information:

Birth date (for preschoolers): 
or
 Last grade completed in school:

Medical Information:
Medical or other information we need to know
(Please include any food allergies.)

Emergency Contact:
Name:*
Phone:*
 Name: 
Phone: 

Dismissal Information:
Who may pick up your child at the end of each VBS day?

Other Information:
 Do you attend Sunday School? If so where?

May we have permission to photograph your child?  Yes   No

May we have permission to use your child's photograph in church publications for the purpose of promotion?  Yes   No

* - Required Information