Vacation Bible School Registration! Question Title * 1. Participant's Information Name Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number OK Question Title * 2. Parent/Guardian names(s) OK Question Title * 3. Participant's Birthday Birthdate Date OK Question Title * 4. Grade completed (if in school) OK Question Title * 5. Gender OK Question Title * 6. Food allergies and/or medical concerns OK Question Title * 7. Emergency Contact Information (this person will be called if the parent/guardian(s) cannot be reached. Name Phone Number OK Question Title * 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. Name 1 Phone 1 Name 2 Phone 2 OK Question Title * 9. Media Permission I hereby grant Epiphany Lutheran Church permission to photograph/film the above participant in any manner/form for any lawful purpose for the ministry of the church. OK Question Title * 10. Is there anything else we should know about your child? OK DONE