|
Big Apple Adventure
Where Faith and Life Connect
June 12th - 15th
VBS 2011 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
|