VBS Registration Form Parent/Guardian First & Last NameEmail Address *Phone *Street Address *Apartment, suite, etcCityState/ProvinceZIP / Postal CodeRelationship to Child *Select OneMotherFatherStep-FatherStep-MotherGrandparentOtherRelationshipIs your contact information already on file at Community EC? *YesNoUnsureChild InfoChild NameBirthdateAgeGrade Completed, or pre-school (VBS only goes through 5th grade) *Allergies or Other NotesAuthorized AdultsHow did you hear about our VBS?Consent to PhotographyI hereby grant Community Evangelical Church the right to copyright, reproduce, publish and otherwise use my child's photograph in any and all media for the purposes of advertising and promoting Community Evangelical Church. I hereby waive any causes of action I may have because of the use of my child's photograph and/or name. I understand that checking the box below and entering my first and last name in the signature box above constitutes a legal signature confirming that I acknowledge and agree to the above Authorization.Send Message
