Register for VBS

Family Information

Parent/Guardian 1 Relationship to Student Parent Grandparent Legal Guardian Other

Parent/Guardian 2 Relationship to Student ------ Parent Grandparent Legal Guardian Other

Mailing Address

Phone and Email

Primary Phone

Alternate Phone

Emergency Contact Information

This is the first person we will contact in case of illness, injury, etc. during Vacation Bible School.

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Pick-up List

Please list the names of individuals who are permitted to pick up your child/children from Vacation Bible School.

Student Information

Gender

Birth Date

Age Group

Medical Information

If your child has food allergies or medical information we should know about, check the relevant box and enter details in the text box.

Food Allergies

Details

Medical Concerns

Details

Image Use Permission

I hereby grant permission for Fairhaven Baptist Church to record sounds, images, and/or video of my child while attending this Vacation Bible School program. I also give permission for Fairhaven Baptist Church, at its sole discretion, to use these sounds, images, and/or videos in publications (including print, websites, and social media platforms) owned by Fairhaven Baptist Church in relation to this Vacation Bible School program.

Choose one

Comments

Is there anything else you wish for us to know about your child? Use this area to tell us.

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