VBS 2019 Registration Consent Form Name Age Address City Zip Code Home Phone Cell Phone Work Phone Email Parent(s) Name In case of emergency contact Allergies or other medical conditions Family Doctor Grade last completed —Please choose an option—123456789101112K Home Church Person who will dop offf Person who will pick up My Child has permission to participate in Vacation Bible School Yes Does not need transportation No Needs transportation Yes Date (MM/DD/YYYY) Please sign your signature with your cursor below Your Name (required) Your Email (required) Subject Your Message