Vacation Bible School Registration

👤 Child’s information

Child’s Full Name

Gender

Date of Birth

Grade Entering

👥 Parent / Guardian & Contact

Parent / Guardian Name

Phone Number

Home Address

Is your child a visitor (does not regularly attend here)?

➕ Emergency & Safety

Emergency Contact Name

Emergency Contact Phone

Allergies (Food or Other)

Medical Conditions / Medications

Authorized To Pick Up Child

Would a Parent Like To Volunteer?

Please Note: Anyone wanting to volunteer must register in time for a background check to be completed.

✅ Permissions

I give permission for my child’s photo or video to be used in church materials, social media, and promotional content.

Yes

Medical Emergency

In a medical emergency, if I cannot be reached, I authorize VBS staff to seek emergency treatment for my child, and I release the church and its volunteers from liability except in cases of gross negligence.

Email: phillipfbc@gmail.com
Phone: 980-256-1072

3207 Wesley Chapel Stouts Road, Monroe NC 28110

Mailing Address:
PO Box 714, Monroe NC 28111