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FAMILY INFORMATION
STUDENT INFORMATION
*
Indicates required field
Parent/Guardian Name
*
First
Last
Please list the following information in the text box below: Name, Gender, Birthday, Grade in Spring 2021
*
Parent/Guardian Email
*
Any food allergies (Please list name and type)?
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Any medical concerns (Please list name with description)?
*
Phone Number
*
This phone is a:
*
Home Phone
Cell Phone
Work Phone
Emergency Contact
*
First
Last
Emergency Contact Relationship to Child
*
Emergency Contact Phone Number
*
Permission to use images and video
I hereby grant permission for Greendale Baptist Church to record sounds, images, or video of my child(ren) while attending Vacation Bible School. I also give permission for Greendale Baptist Church at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Greendale Baptist Church.
Photo Release Name
*
First
Last
Photo Release Date
*
*By typing my name and date above, I agree to use this as my signature for this permission form.
Register Students
Home
Visit
VBS
VBS Registration
Sermons
About
Our Story
Our Beliefs
Our Staff
Calendar
Videos
Online Giving