Contact 3 — Immanuel Baptist Church

VBS REGISTRATION FORM GRADES 1 - 5

VBS Form

Child's Name

First Name

Last Name

Age and Grade Entering

Parent/Guardian's Name

First Name

Last Name

Phone

(###)

###

####

Email

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Allergies/Special Info

Emergency Name and Numbers

Guest Of

Church Affiliation

Persons authorized to pick up your child

May we take pictures of your child for church presentation of activities done during VBS and our website?

Checkbox

Yes

No

How Did You Hear About Us?

DAILY CHALLENGE POINTS

FIND AND KNOWING WONDER NUGGET

WEAR WESTERN ACCESSORY OR COSTUME

KNOW MEMORY VERSE

BRING A VISITOR

GIVE TO FOOD PANTRY