For Students Completing PK-4 through 4th grades

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* Please provide the following information about your child:

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* Parent or Guardian Name

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* Address

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* E-mail Address

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* Phone numbers

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* Child's date of birth

Date

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* Grade child completed this school year.

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* Home  church (If any)

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* Special needs/allergies/medical information/other information we need to know about the child.

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* Emergency Contacts (Please provide 2)

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* Name(s) of person(s) who may pick up this child from VBS

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* By typing your name in the box below, you are giving St. Francisville United Methodist Church permission to use your child's photograph publicly in VBS materials. You are also acknowledging that the images may be used in print publications, online publications, presentations, on the church website and in social media publicity about VBS. In addition, you are acknowledging that no royalty, fee or other compensation shall become payable to you by reason of image use.

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* Please indicate your child's t-shirt size.

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