VBS Registration-FBC Gilroy

Child's name:		Last grade completed:
Parent's/Guardian's name:
Birth Date, must include birth year
Address:		City
State:		Zipcode:
Home Phone:		Work Phone:
Cell Phone:		Email:
Medical Info (including food allergies)
Emergency Contact:		Phone:
Who may pick-up your child from VBS?:
If you go to Sunday School, please tell us where:		How did you hear about VBS?:
Photographs of children maybe used in promotions