VBS Registration Form

June 23rd - 26th 6:00pm - 8:00 pm

Please note VBS is for students K-5th Grade.

Please fill out the following to sign up for Vacation Bible School. Please provide us with a MAILING ADDRESS in order for us to send you an end of the summer party invite.

Child's Name

Gender

Last Grade Child Completed

Child's Age

Child's Birthdate

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Known Allergies and Reaction or Medical Condition

What church do you currently attend?

How did you hear about our VBS?

I, __________________________ am the parent or legal guardian of _____________________________, (hereinafter "my child") and I am informed of the VBS activities offered by Edmund Blvd Baptist Church (hereinafter "church") located at: 1405 Edmund Blvd, in the City of San Angelo, in the county of Tom Green, and State of Texas, beginning on the day of Tuesday, 6/11/2019 and ending on the day of Thursday, 06/13/19. Further, I consent to the use of any video images, photographs, audio recordings, or any other visual or audio reproduction that may be taken of the child/participant during their participation in any activity, event or trip to be used, distributed, or shown as said church sees fit but not exclusive to: slide shows, church web site, print media or local newspapers.

As the parent or legal guardian of this child, I hereby consent for this child to attend and participate in all activities provided by this church.

Emergency phone # where you can be reached

(###)

###

####

Parent Name

First Name

Last Name

Signature

Additional Information

Our Office

1405 Edmund Blvd
San Angelo, TX 76901

(325) 944-2662