2nd Baptist Church
Wednesday, October 26, 2016
Sundays 8:30 & 11am Wednesdays 6pm
Child's Name: 
Birth Date:           Age:   
Last grade completed: 
Parent/Guardian Name: 
Home Phone:          Cell Phone: 
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