EmailMe Form - Community VBS 2025

Parent/Guardian Name *

First Last

Parent/Guardian Name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Family Email *

Phone *

### - ### - ####

Phone

### - ### - ####

Home Church

My children have Bibles they can use at home after VBS.

Classroom Bibles will be provided for use during the week.

Child Information

Please enter info for each child you are registering.

Please note, VBS will include large group worship in the auditorium with moving lights and lots of sound.

1 - Child's Name *

First Last

1 - Gender *

Male

Female

1 - Grade Completed *

1 - Birthdate *

MM / DD / YYYY

1 - Allergies / Medical / Other Needs

1 - Child's Shirt Size *

1 - Do you need to register another child in this household?

2- Child's Name

First Last

2 - Gender *

Male

Female

2 - Grade Completed *

2 - Birthdate *

MM / DD / YYYY

2 - Allergies / Medical / Other Needs

2 - Child's Shirt Size *

2 - Do you need to register another child in this household?

3- Child's Name

First Last

3 - Gender *

Male

Female

3 - Grade Completed *

3 - Birthdate *

MM / DD / YYYY

3 - Allergies / Medical / Other Needs

3 - Child's Shirt Size *

3 - Do you need to register another child in this household?

4- Child's Name

First Last

4 - Gender *

Male

Female

4 - Grade Completed *

4 - Birthdate *

MM / DD / YYYY

4 - Allergies / Medical / Other Needs

4 - Child's Shirt Size *

4 - Do you need to register another child in this household?

5- Child's Name

First Last

5 - Gender *

Male

Female

5 - Grade Completed *

5 - Birthdate *

MM / DD / YYYY

5 - Allergies / Medical / Other Needs

5 - Child's Shirt Size *

Emergency Contact Information

Please enter the name of the parent or guardian who should be contacted in case of an emergency.

Name *

First Last

Relationship

Phone *

### - ### - ####

Additional Contact Information

Please enter the name of one additional contact beyond the parent / guardian.

Name *

First Last

Relationship

Phone *

### - ### - ####

Permissions

Photo and Accident Release

Parental / Guardian Responsibility *

By checking this box I am over 18 and responsible for the child/children listed on this form and will not hold South Adams Schools or Sponsoring Churches responsible for injury / accident.

Permission for Photos *

By checking this box I am giving my permission for my child/children's photos to be used for promotional purposes.

My child may NOT have any photos taken.

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