VBS Student Registration Name of Student * First Name Last Name Name of Parent/Guardian * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Student D.O.B * MM DD YYYY Student Age * Student Shirt Size * XS S M L XL Last school grade completed * Home Church (if any) Friends of your child at this church Special Needs/Allergies/Medical Information/Other: * Emergency Contacts Name of Emergency Contact #1 * First Name Last Name Phone of Emergency Contact #1 * (###) ### #### Name of Emergency Contact #2 * First Name Last Name Phone of Emergency Contact #2 * (###) ### #### Name of person(s) who may pick the student up from VBS * Photo Release * Lifehouse Fellowship Church/VBS has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. Permission Granted Permission Denied Thank you for registering your student for VBS. We look forward to seeing you this summer!
