VBS Registration

    Vacation Bible School 2021

    Child's Name

    Parent's Name(s)


    City, State, Zip Code

    Date of Birth

    Grade Just Completed

    Home Phone

    Parent Cell Phone

    Parent Email

    Attend what church?

    List all allergies

    List major illnesses

    List regular medications

    Emergency Contact #1

    Phone #1

    Emergency Contact #2

    Phone #2

    Who will pick up child?

    My child will follow all COVID Protocols designed to make VBS a safe and healthy experience.
    Crowfield Baptist Church has my permission to publish any pictures that the above named child might appear in on their website, in power point presentations, or in their newsletter or other church publications.

    Comments or Questions