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Registration Form
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BeaverDam Baptist VBS 2018
Child's Name
*
Your answer
Child's Age
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Your answer
Child's Gender
*
Female
Male
Last Grade Completed
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Choose
Preschool
Kindergarten
First
Second
Third
Fourth
Fifth
N/A
Parent(s) Name
*
Your answer
Street Address
*
Your answer
Email
*
Your answer
Phone number (1)
*
Your answer
Phone number (2)
Your answer
Allergies or other medical conditions.
Your answer
Emergency Contact
*
Your answer
Emergency Phone
*
Your answer
Relationship to child
*
Your answer
Do you have a friend or sibling you would like to be placed with? If so, who?
Your answer
Additional Comments
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Photo Consent
I consent to having my child's picture on BeaverDam's website or social media.
I do not consent to having my child's picture on BeaverDam's website or social media.
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