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* 1. Child's Name

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* 2. Child's Current Age

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* 3. What is the address where you currently live?

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* 4. What is a phone number you can be reached at during the event? On the second line, please list an alternate name/phone number in the unlikely event of an emergency.

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* 5. Child's Date of Birth

Date / Time

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* 6. Do you or your children attend church? If so, where?

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* 7. Parent or Guardian's Name(s)

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* 8. Important: Does your child have any medical issues/allergies/ or other information that would be helpful to our VBS staff?

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* 9. Do you give your permission for your child to be photographed? We use these photos on social media, in a slideshow, etc. Please list YES or NO and any restrictions on this. 

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* 10. What is your email address? We will ONLY use this to contact you about future events which you may be interested in from RUMC or TMBC. We will NEVER share your information or sell it to anyone. 

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