Instructions: Fill out this form and press the "Submit" button to send the completed form to the church. Or, if you wish, print and mail a PDF version of the same form (available here) to our address, drop it off at the church office at any time, or drop it off at the registration table on the first day of VBS. Thanks!
Name of Parent/Guardian: Address: Phone #: Cell #: Email: Family Doctor: Phone #: Emergency Contact: Phone #: Alternate Emergency Contact: Phone #:
Food Allergies: Medical Conditions: Member of a Church? Yes No (If yes, name of church: ) Are children baptized? Yes No Do you need transportation? Yes No Can you furnish transportation for other children in your neighborhood? Yes No Permission to post child's photo on a secure portion of the FLC website? Yes No
