Name of Parent/ Guardian This field is required. Child's Name This field is required. Address: This field is required. Mailing Address (if different) Home Phone Number Work Phone Number Cell Phone Number This field is required. Email This field is required. Date of Birth This field is required. Last Grade Completed in School This field is required. Medical or other information that we need to know (Please include any food allergies) This field is required. Please put "None" if there aren't any Emergency Contact Names and Phone Numbers (other than listed above) Does your child need transportation to and from VBS? Yes, Please schedule a time to pickup my child. No, I will be bringing my child to VBS each day. Who May Pick up your child at the end of each VBS day? This field is required. Does your child attend church regularly? If so, Where? Is your child visiting our church, who are they a guest of or how did you hear about us? Photo Release: I agree. I do not agree. Gallatin Church of God of Prophecy has my permission to use my child's photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use. Submit
