VBS Kingdom Quest Registration

Parents Full Name *Enter your full name.

Street Address

City, State, and Zip Code

Phone Number Please include are code

Home E-Mail Address *

Please choose one of the following

I do not give permission to receive emails about future events at Grace Bible Church.

I give permission to receive emails about future events at Grace Bible Church.

Home Church (Optional)

Please list your child's name, age, school-year completed, and any allergies, medical conditions, or special needs they may have. Child One

Please list your child's name, age, school-year completed, and any allergies, medical conditions, or special needs they may have. Child Two

Please list your child's name, age, school-year completed, and any allergies, medical conditions, or special needs they may have. Child Three

Please list your child's name, age, school-year completed, and any allergies, medical conditions, or special needs they may have. Child Four

Please list your child's name, age, school-year completed, and any allergies, medical conditions, or special needs they may have. Child Five

In Case of Emergency, Contact *Enter First and Last Name

Emergency Contact's Phone Number Please include area code

Emergency Contact Relationship to Child

I have read the PHOTO RELEASE TERMS & CONDITIONS and either agree with it, or decline it, based on my following choice: *

I AGREE to allow my child(ren)'s photo to be used judiciously and solely for promotional purposes of the GBC VACATION BIBLE SCHOOL event.

I DO NOT AGREE for my child's photo to be used in any fashion or for any reason without my express written approval, which is not given at this time.