Registration for children K-5th grades

First Name

Last Name

Phone Number

Email

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Name of Child

Grade

Allergies

Name of Child

Grade

Allergies

Name of Child

Grade

Allergies

Name of Child

Grade

Allergies

Name of Child

Grade

Allergies

By attending Vacation Bible School (VBS), you grant Phoenix at Century Park Churxh permission to photograph and/or video your child for use in church-related promotional materials, both online and in print.

Yes

No

Signature