Registration Form
Child’s Name  Parent/Guardian Name ____________________________________________________________

Address ________________________________________________________________________________
(street address, city, state, and zip code)
Mailing Address (if different) 

Contact Information

Home ________________________________________     
Work ________________________________________     Cell ____________________ 
Email ____________________________________________________________

Age Information

Birth date   Last grade completed in school 

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

Emergency Contacts (other than listed above)
Names & Phone numbers 

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

Other Information
Does your child attend Sunday School? If so where? 

If your child is visiting our church, who is he a guest of?

May we have permission to photograph your child?   Yes          No

May we have permission to use your child’s photograph for the purpose of promotion?   Yes         No
Registration Form • Administrative Guide Printable • VBS 2021

Adult Registration Form
Name   

Address (street address, city, state, and zip code) 

 
Mailing Address (if different)

Contact Information

Home ________________________________________     
Work ________________________________________     Cell ____________________ 
Email ____________________________________________________________

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

If you are visiting our church, who are you a guest of?

May we have permission to photograph you?    Yes         No

May we have permission to use your photograph for the purpose of promotion?   Yes        No

Adult Registration Form • Administrative Guide Printable • VBS 2021