Parent/ Guardian Name * First Name Last Name Parent/ Guardian Phone * (###) ### #### Parent/ Guardian Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Child's Name * First Name Last Name Grade Starting in the Fall * Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade T-shirt size * Permission for Child's Photo to be taken and Used for promotion * Yes No Emergency Contact Name * First Name Last Name Emergency contact Phone * (###) ### #### 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? * Any Additional information you would like us to know? You’re child is now registered for VBS!Please contact the office with any questions are concerned!