VBS 2023

June 12-16 Monday - Friday 9am to 12noon

Please fill out all of the information for each child you are registering.

Parent/Guardian Name: *
Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent/Guardian Home Phone: - ### - ### ####
Parent/Guardian Mobile Phone: - ### - ### ####
Parent/Guardian Email: *
Is anyone other than the parent/guardian listed above allowed to pick up your child(ren)? *

Is anyone other than the parent/guardian listed above allowed to pick up your child(ren)? Yes No
If Yes, please enter this person's name and phone number:
Alternate Pick Up Phone - ### - ### ####
Are you the parent interested in volunteering for Vacation Bible School? *
Child 1:
Child 1 Name: *
Child 1 Date of Birth: * / MM / DD YYYY
Child 1 - Grade Entering in the Fall of 2023: *

Child 1 - Grade Entering in the Fall of 2023: Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7
Child 1 -Special Needs or Allergies:
Child 1: Snyder Memorial Baptist Church, has my permission to photograph my child and use the photo in our church publications. *
Yes No
Child 2:
Child 2 Name:
Child 2 Date of Birth: / MM / DD YYYY
Child 2 - Grade Entering in the Fall of 2023:

Child 2 - Grade Entering in the Fall of 2023: Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7
Child 2 -Special Needs or Allergies:
Child 2: Snyder Memorial Baptist Church, has my permission to photograph my child and use the photo in our church publications.
Yes No
Child 3:
Child 3 Name:
Child 3 Date of Birth: / MM / DD YYYY
Child 3 - Grade Entering in the Fall of 2023:

Child 3 - Grade Entering in the Fall of 2023: Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7
Child 3 -Special Needs or Allergies:
Child 3: Snyder Memorial Baptist Church, has my permission to photograph my child and use the photo in our church publications.
Yes No

VBS 2023

VBS 2023

Child 1:

Child 2:

Child 3: