Parent/Guardian Name*

First Last

Child's Name*

First Last

Enter one child's name here. If there are additional children, please fill out a separate form.

Child's Gender*

Male
Female

Birthdate*

What is your child's birthdate?

Allergies or Medical Conditions*

Please describe any allergies or medical conditions we need to be aware of below or write 'none' in the blank field.

Age Group*

Pre-Kindergarten
Kindergarten
1 grade
2 grade
3 grade
4 grade
5 grade
6 grade

Please check the box next to the grade your child has finished (or will have finished) in May 2021.

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent's Email*

Parents Primary Phone*

Please list the number where we can reach you during VBS.

Emergency Contact Name*

First Last

Who should we call in case of an emergency?

Relationship to child*

Emergency Contact Phone*

Authorize alternate pick up

Please list up to three people (other than yourself) who are authorized to pick your child up.

T-Shirt Size*

Child Small
Child Medium
Child Large
Adult Small
Adult Medium
Adult Large
Adult XL

Photographic consent*

Yes
No

Please indicate whether or not you authorize First Baptist Church to publish photographs taken during VBS for use in FBC publications. I understand that my child's full name will not be named in any publications.

Compassion Camp: In-Person Vacation Bible School

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