Parent/ Guardian Name * First Name Last Name Child's Name * First Name Last Name Grade your child will be starting in the Fall * Pre-K (4 years old) Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade T-shirt size * Any Additional information you would like us to know? Parent/ Guardian Phone * (###) ### #### Parent/ Guardian Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Mailing Address if different than physical address Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency Contact Name * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Emergency contact Phone * (###) ### #### Permission for Child's Photo to be taken and Used for promotion * Yes No Medical or other information we need to know (Please include any food allergies) * Please list adults other than parent or guardian authorized to pick up student? * You’re child is now registered for VBS!Please contact the office with any questions are concerned!