Monday, March 25, 2019
Win People to Christ and Minister to all
 Thank you for taking the time to pre-register for Vacation Bible School.
We look forward to seeing you at our VBS Kick Off on June 10 at 5:00 pm.
Child's Name:
Parent/Guardian Name:
Address Where Child Lives
City:  State:  Zip:
Contact Information
Phone Number: Cell Landline
Alternate Phone number: Cell Landline
Email Address:
Age Information
Date of Birth   Last Grade Completed:
Medical Information
Please list any Allergies or other Medical Information below:
Emergency Contact Information
Emergency Contact Name:  Phone Number:
Emergency Contact Name:  Phone Number:
Dismissal Information
Name of Person(s) who may pick up this child from VBS: 
Church Information
Does this child attend church/Sunday School regularly?  Yes   No
If yes, what church do they attend?  New Bethel Baptist Church  Other
If other, please give the name of the church they attend 
Media Release 
Do you give permission for New Bethel Baptist Church to take pictures/videos of your child during VBS that may be used on our website or shared during our worship service?  Yes  No
Thank you for taking to time to register your child for VBS at New Bethel Baptist Church.