Register
Child's name
Grade completed
Birthday
Age
Parents' names
Home address
Home phone
Alternate phone
Emergency contact person
Relationship to student
Emergency contact home phone
Emergency contact alternate phone
Food allergies
Y
N
Food allergies list
Medical concerns
Y
N
Medical concerns list
Family doctor
Doctor's phone
Siblings attending VBS (names & ages)
Church affiliation
Church membership at
People who may pick up the child
Transportation needed?
Y
N
Attendance
1
2
3
4
5