Calvary Bible Church

VBS Registration

• Parents'/Guardian's Names*
  First Name

  Last Name
• First Name

  Last Name
• Your E-mail*
   
• Address*
  Street Address*

  Address Line 2

  City*

  Province / State / Region*

  Postal Code / Zip

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  Country*
• Phone Number*
   

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• Phone Number-Work
   

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• Emergency Contact*
  First Name

  Last Name
• Phone Number
   

  (###)

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• Relationship to Child(ren)
• Emergency Contact
  First Name

  Last Name
• Phone Number
   

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• Relationship to Child(ren)
• Who else may sign child(ren) out of camp (besides parent/guardian)
  First Name

  Last Name
• First Name

  Last Name
• Do you give consent to take your child's photo and use it on social media for advertising purposes?*
  Yes

  Yes, but only if face is not showing

  No, please don't post anything with my child's photo and use it on social media
• 1st Child's Information*
  First Name

  Last Name
• Date of Birth*
  MM

  /

  DD

  /

  YYYY
• Age *
• 2nd Child's Information
  First Name

  Last Name
• Date of Birth
  MM

  /

  DD

  /

  YYYY
• Age *
• 3rd Child's Information
  First Name

  Last Name
• Date of Birth
  MM

  /

  DD

  /

  YYYY
• Age *
• 4th Child's Information
  First Name

  Last Name
• Date of Birth
  MM

  /

  DD

  /

  YYYY
• Age *
• Does your child/children have any developmental/physical/behavioural challenges/needs that we should be made aware of?
  Please specify which child and issues
• At VBS we serve nut-free snacks. Does your child/children have any food allergies that we should be aware of?
  Please specify which child and specific allergies