Vacation Bible School, VBS, FBC Brunswick

Child's First Name

Child's Last Name

Parent/Guardian Name


(street address, city, state and zip code)

Mailing Address

(if different)

Home Phone Number

Cell Phone Number

Work Phone Number

Email Address

Child's Birth Date

Last Grade Completed in School (Spring 2019)

Medical Information

Medical or other information we need to know. (Please include any food allergies.)

Emergency Contacts (other than listed above)

Names & Phone Numbers

Dismissal Information

Who may pick up your child at the end of each VBS day?

Does your child attend Sunday School? If so, where?

May we have permission to photograph your child?

May we have permission to use your child's photograph for the purpose of promotion?

If your child is visiting our church, who is he/she a guest of?