Register for VBS

Family Information

Address

Primary Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Student Information

Gender

Birth Date

Age Group

Who may pickup your child? Please note the above should include all those that may pickup your child throughout the week of VBS (including you, the parents). If the name is not listed above, we will be unable to release your child to that individual until contact is made with you.

Food Allergies

Details

Medical Concerns

Details

Acknowledgement

By completing this form and checking the box below I give Neuse Baptist Church permission to photograph my child for VBS purposes. I understand these photos may be used for various activities, events, recognition, promotional material and church history records.

Check below to agree to acknowledgement.

I have more students to register