VBS Registration Form

 
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Please complete a separate registration form for Each child.

 
Child's Name *
Child's Name
Parent/Guardian's Name *
Parent/Guardian's Name
Parent/Guardian's Phone *
Parent/Guardian's Phone
Best Way to Reach You? *
*** If someone other than you will be picking up your child, please complete the following... Person Picking Up Child
*** If someone other than you will be picking up your child, please complete the following... Person Picking Up Child
Does your child have any allergies, medical concerns or special needs? (This will be kept private and is only necessary for the safety and protection of your child!) *
In the event of an emergency, do we at Lakeside Presbyterian Church, along with VBS volunteers, have your permission to help your child however necessary until the appropriate help arrives? *