Registration

Grace Community Baptist Church
Pastor AJ
503-325-2263

Printable Registration Form

Bethany Lutheran Church
Pastor RIch
503-325-7135

Please use this form to register your children individually.

Name of Child

First Name

Last Name

Name of Parent/Guardian

First Name

Last Name

Primary Phone

(###)

###

####

Secondary Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Age

How old will you be during VBS?

Grade

What Grade did your child last complete in school?

Medical

Medical or other information that we need to know (Please include allergies)

Emergency Contact Person

(Different from above)

First Name

Last Name

Phone

(###)

###

####

Other Information

Dismissal Information

Who may pick up our child at the end of each VBS day?

Home Church

Do you have a home church? If so, please list the name and town it is in.

If your child is visiting our church, who are they a guest of?

Do we have permission to photograph your child?

(During VBS we will take pictures to make a short video for the party at the end. Some photos may be used for promotional purposes)

Yes

How did you hear about VBS?

Please let us know how you heard about VBS this year. Did you hear about it at church, on social media, from a friend? Thanks for helping us learn better how to promote VBS next year!