VBS Registration Form

Parent/Guardian Information

Parent/Guardian Name

Cell Phone

This address will receive a confirmation email

Relationship to Child

Emergency/Pick-up Info

1st Emergency Contact Name

Cell Number

2nd Emergency Contact Name

Cell Phone Number

Authorized to pick up name

Cell Phone

Children

1st Child First Name

1st Child Last Name

1st Child Birthday

1st Child Gender

1st Child Grade Completed:

T shirt size ($15/each)

1st Child Allergies/Special Needs. Write n/a if none.

2nd Child First Name

2nd Child Last Name

2nd Child Birthday

2nd Child Gender

2nd Child Grade Completed:

T shirt size ($15/each)

2nd Child Allergies/Special Needs. If none type n/a.

3rd Child First Name

3rd Child Last Name

3rd Child Birthday

3rd Child Gender

3rd Child Grade Completed:

T shirt size ($15/each)

3rd Child Allergies/Special Needs. If none please type n/a

4th Child First Name

4th Child Last Name

4th Child Birthday

4th Child Gender

4th child grade complated:

T shirt size ($15/each)

4th Child Allergies/Special Needs. If none please type n/a

Visitors Only: Who are you coming with and what is their relationship to you?

Photo Permission

I give my child permission for the use of photographs and videos of my child taken when at a Five Points Baptist event to be used on the Five Points webpage, social media, and other promotional materials.

Yes No

T-shirts ($15/each) pay through the church app/cash/check

Your confirmation emai has a sample VBS shirt.
Confirmation page & your confirmation email both have links if you would like to purchase t-shirts. Shirts must be purchased by May 23rd. Cost: $15/shirt

Description

June 24-27th | 5-8:30pm (nightly)

Celebration Night | June 28th
Drop off/check-in for the kids 4:30-5pm each night.
Food will be provided for kids each night following check-in
Pick-up begins at 8:30pm
The deadline to order t-shirts is June 9th!!
To register please fill out this form and click submit.

VBS Registration Form

Description

Please Fix the Following