Children Registration Form VBS Puzzling Pyramids

CHILD INFORMATION

Child's Name

Age

Date of Birth

Last Grade Completed

GUARDIAN INFORMATION

Parent/Guardian Name

Mobile Phone

Work Phone

This address will receive a confirmation email

EMERGENCY INFORMATION

Food Allergies?

Yes No

If Yes, list allergies

Medical Concerns

Yes No

If yes, list concerns

Emergency Contact First and Last Name

Emergency Contact Phone

Relationship

Emergency Contact First and Last Name

Emergency Contact Phone

Relationship

Doctor

Doctor's Phone

RELEASE INFORMATION

Who is authorized to pick up your child?

Relationship

Who is authorized to pick up your child?

Relationship

Anyone who participates in worship or ministry with VBS Puzzling Pyramids with Living Hope Church and GraceLife may be photographed for use on our website or social media channels. If this is a concern with you, please check below.

I do not want photos of my child to appear in Living Hope’s social media or its website.

SIGNATURE

Parent/Guardian Signed

Today's Date

Description

Please complete one form per child for VBS Puzzling Pyramids registration.

Children Registration Form VBS Puzzling Pyramids

Description

Please Fix the Following