VBS Registration – Faith Baptist Church

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Child 1 Name *

First

Middle

Last

Child 1 Birthday *

Child 1 Grade Entering in Fall *

Child 1 Allergies? *

Yes No

If yes, List Child 1 Allergies

Page 2

Child 2 Name (Required)

First

Middle

Last

Child 2 Birthday (Required)

Child 2 Grade Entering in Fall

Child 2 Allergies? (Required)

Yes No

If yes, List Child 2 Allergies

Page 3

Child 3 Name (Required)

First

Middle

Last

Child 3 Birthday (Required)

Child 3 Grade Entering in Fall

Child 3 Allergies? (Required)

Yes No

If yes, List Child 2 Allergies

Page 4

Additional Information

Parent Name

Mailing Address *

Address Line 1 *

Address Line 2

City *

State *

Zip Code *

Email Address *

Phone Number *

Additional Phone Number

Permission to use photos *

Yes No

Name of person allowed to pick up child other than parent

(Must show I.D.)

Worship Times

Helpful Links

Faith Baptist Church