CAMELLIA BAPTIST CHURCH 2021 Vacation Bible School June 6th - 10th 6:00pm- 9:00pm 3yr Pre-K thru 6th Grade & Adults
**All activities are free**
Child's Full Name
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First Name
Last Name
Child's Parent/Guardian's Name
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First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Cell Phone Number
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Area Code
Phone Number
E-mail
*
Please select
*
Boy
Girl
Child's Date of Birth:
*
Must be 3yrs of age by June 1st and fully potty trained to eligible to attend
Last Grade Completed
*
Last Grade Completed
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3yr (Fully potty trained)
4yr
5yr
K5
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
(VBS Team/Volunteers Only)
Adult Class
For Volunteers Only. What area are you serving
*
Camellia Baptist WEM Daycare family?
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Yes
No
Additional/Emergency Information
(1) Emergency Contact Name
*
(1) Emergency Phone Number
*
-
Area Code
Phone Number
(2) Emergency Contact Name
(2) Emergency Phone Number
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Area Code
Phone Number
*Medical, Allergies or Special Needs (If no alergies or special attention required, please indicate as N/A)
Dismissal Information: Authorized person who may pick up your child at the end of each VBS day?
Other Information
Does your child attend Sunday School?
*
Yes
No
(Yes or No)
If so where?
If your child is visting our church, who is he a guest of?
May we photograph your child?
*
Please Select
Yes
No
(Yes or No)
May we have permission to use your child's photograph for the purpose of promotion?
*
Please Select
Yes
No
(Yes or No)
Please Note: All children must be registered by child's parent or legal guardian. All children are to be checked in at designated entry doors. Parents and/or authorized person is to pick up child from at same location
Submit
Should be Empty: