Second Baptist Church of Rutherfordton
Wednesday, July 30, 2014

VBS Registration Form

 
Child's Name: 
Birth Date:   Age:   Last grade completed: 
Parent/Guardian Name: 
Address: 
 
Home Phone:   Cell Phone: 
Email: 
Allergies: 
Emergency Contact (Name and Phone Number): 
Emergency Contact 2 (Name and Phone Number): 
Who may pick up your child at the end of each VBS day? 
Does your child attend Sunday School? If so, where? 
If your child is visiting our church, who is he/she a guest of? 
May we have permission to photograph your child?   Yes No
May we have permission to use your child's photograph for the purpose of promotion?  Yes  No