VBS Online Registration

If you would like to participate in VBS as a Learner, please complete the following form. If you are under 18, please have your parent or guardian complete the form.

Parent/Guardian Name
Child's Name
Gender	Male Female
Address
City
State
Zip
Home Phone
Work Phone
Cell Phone
Date of Birth
Grade Just Completed
Do you attend Sunday School?	Yes No
If so, where?
Who is allowed to pick up your child each day?	(must be at least 16 years old)
In case of an emergency, who do we call?
Please list any allergies, including food, medications, or other important medical information.
Transportation:
Will your child need church provided transportation?	Yes No
Pick-up Location:
Transportation is for those who could not attend without it. Children must be 4 years old or older to ride in the church provided transportation.

Enter any additional comments in the space provided below:

By checking this box, I give permission for my son/daughter, to attend Vacation Bible School July 14-18, 2008. I give the adult sponsors of Grace Baptist Church Vacation Bible School the authority to provide or sign for medical treatment for my child. I do not hold Grace Baptist Church liable for any injuries or illnesses incurred during this camp or while riding in the church provided transportation. I also give permission for my child’s photo(s) to be placed on the church web site (www.gbcky.org) for viewing purposes only.