Petrolia VBS Registration

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A Community Approach

First Baptist Church, Christ Church Anglican, St. Andrew’s Presbyterian, St. Paul’s United

July 16th - 20th, 2018
9:30 – 12:30 daily
Ages: 5 – 12 years
petroliavbs.weebly.com for more info

WE RESPECT YOUR PRIVACY AND WILL NOT SHARE YOUR RESPONSES WITH THIRD PARTIES

Child's Full Name *

First and Last

Street Address *

City *

Home Phone *

Birth Date of Child *

Children born from 2006-2013 only please

YYYY

Parent (Guardian)'s Name *

Relationship to Child *

Contact Phone *

Alternate Phone

Emergency Contact *

Emergency Contact's Phone *

Allergies or Medical Issues? *

Yes

If yes, please explain:

Any Emotional or Behavioural Issues? *

Yes

If yes, please explain:

"I give my permission to have my child's photo taken during VBS" *

Yes

Any other special considerations?

(we will try to put your child in a group with any requested friends but cannot make this a guarantee)

Submit

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