VBS Registration Form Child's Name This field is required. Child's Age Child's Birth Date Child's Grade ( K, 1, 2, 3, etc...) Address: This field is required. Home Phone Number Work Phone Number Cell Phone Number This field is required. Email This field is required. Preferred Method of Contact ( Phone, EMail, etc..) 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) Who May Pick up your child at the end of each VBS day? ( Name & Relationship of each person allowed) This field is required. Does your child attend church regularly? If so, Where? If your child is visiting our church, who are they a guest of or how did you hear about us? 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. Permission to Baptize? Yes No 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. Name of Parent/Guardian providing information and permissions on this form. This field is required. Captcha Submit
