Gracepoint’s VBS 2024

Child #1

First Name

Last Name

Child #2

First Name

Last Name

Child #3

First Name

Last Name

Child(s) Age(s)

Child(s) Current Grade

Parent's Name

First Name

Last Name

Parent's Email

Parent Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Does your child have any allergies?

Does your child have any special needs?

Who may pick up your child from VBS?

Child's T-Shirt Size

Photography/Videotaping Release: I hereby give consent for my child to be photographed or videotaped for promotional use by GracePoint. Footage will not be forwarded to any third party.

Do you have a home church?

Yes

Electronic Signature: By typing my initials below, I give permission for my child to participate in activities at GracePoint, and release Gracepoint of any liability. I hereby authorize the volunteers and GracePoint staff to administer emergency medical first aid treatment or to call for emergency services.