Vacation Bible School

June 16-20, 2008

Personal Information:

Parent Name

Street Address

Mailing Address

City

State/Province

Zip/Postal Code

Work Phone

Home Phone
E-mail Address*
*Please provide an email address for confirmation of your registration, reminders and updates regarding VBS 2008
Emergency Contact

Name

Work Phone

Home Phone
Additional Emergency Contact

Name

Work Phone

Home Phone

Please indicate name, grade completed, allergies or other info we might need to know of each child you would like to register:
Dismissal Information: Who may pick up your children at the end of each VBS day?
(Please include all names)
Submitted by

        Parent
        Legal Guardian
        Caretaker
May we have permission to photograph your child/children?

yes
no
May we have permission to use your child/children's photograph in church publications for the purpose of promotion?

yes
no
How did you hear about "Outrigger Island" at FBC Holly Springs?

Williamson Bros. Barbeque
Viva Mexican Restaurant
Grady Street Pizza Co.
Church Sign
Radio
Friend Name of Friend
Other How did you hear?