register-vbs22 - KINGDOM POINT

VBS PRE-REGISTRATION

* Indicates required field

Student's Name *

First

Last

Parents/Family/Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Birthday *

Age *

Last school grade completed *

Home Church (If Any) *

Friends OF Your Child At This Church *

Special Needs/Allergies/Medical Information/Other: *

Emergency Contact *

First

Last

Phone Number *

Emergency Contact *

First

Last

Phone Number *

Name(s) of person(s) who may pick up this child from VBS *

PHOTO RELEASE: KINGDOM POINT CHURCH/VBS HAS MY PERMISSION TO USE MY CHILD'S PHOTOGRAPH PUBLICY IN VBS MATERIALS. I UNDERSTAND THE IMAGES MAY BE USED IN PRINT PUBLICATIONS, ONLINE PUBLICATIONS, PRESENTATIONS, WEBSITES, AND SOCIAL MEDIA. I ALSO UNDERSTAND THAT NO ROYALTY, FEE OR OTHER COMPENSTATION SHALL BECOME PAYABLE TO ME BY REASON OF SUCH USE.................................................Parent/Guardian Signature *

Date *

Submit