* 1. Participant's Information

* 2. Parent/Guardian names(s)

* 3. Participant's Birthday

Birthdate

* 4. Grade completed (if in school)

* 5. Gender

* 6. Food allergies and/or medical concerns

* 7. Emergency Contact Information (this person will be called if the parent/guardian(s) cannot be reached.

* 8. If the parent/guardian will not be dropping of and/or picking up the child at Vacation Bible School, please list below the name(s) and contact number of the other persons responsible for drop-off/pick-up.

* 9. Media Permission

* 10. Is there anything else we should know about your child?

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