Name: Vacation Bible School
Start: 2019-06-17T09:00:00-04:00
End: 2019-06-17T12:00:00-04:00

Parent Information

Parents Name*

First Last

Phone*

Additional Parent

First Last

Phone

Emergency/Alternate Pick-Up (If other than Parent)

First Last

Alternate Contact Number

If you the parent, or the alternate pick up person listed above is unable to pick your child up, a written note must be provided to your child's leader for him/her to be released.

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent Email

Child Information

Child's Name

First Last

Child's Gender*

Male
Female

Child's Birthday (mm/dd/yyyy)*

MM

DD

YYYY

Grade Completed (Select One)*

Allergies or other Concerns? Please list here.

Children with food allergies need their snack to be 100% allergy proof and the parent is the one who can best provide for that need. WakyMc is unable to provide alternative snacks due to various kids of allergies. Parents if your child has allergies please provide an alternative snack sealed in a zip lock bag or disposable sealed container and mark with their name.

What Days will your child be participating?*

Monday
Tuesday
Wednesday
Thursday

Is your child to walk or ride their bike?*

Yes
No

By marking Yes, I give WakyMC permission to release my child from church property without an adult present, so that my child may walk OR ride their bike home, or to another location.

Misc. Details

Do you have a church home?*

Yes
No

By choosing SUBMIT, you are registering your child and agree to the following:

You agree to release WakyMC, its officers, directors, and agents and anyone connected or associated with the church from any liability for injuries to your child arising out of his/her participation in this event.
You agree to allow WakyMC to photograph and videotape your child for use of promotional and/or programming during this event.

Vacation Bible School

Vacation Bible School

June 17 @ 9:00 am - 12:00 pm

VBS Registration Form

Parent Information

Child Information

Misc. Details

Details