FBC Franklinton VBS 2022
If you or your child would like to participate in this event as a Participant, please complete the following form.

(If you are under 18, please have your parent or guardian complete the form.)
Personal Information
*Participant's First Name:
*Participant's Last Name:
*Preferred Name for Name Tag:
Gender:
*Parent/Guardian Name:
*Address:
*City:
*State:
*Zip:
Primary Phone:
(555-555-5555)
Work Phone:
(555-555-5555)
*Cell Phone:
(555-555-5555)
*Email:
*Birthday:
(MM/DD/YYYY)
*Grade:
(*Last Grade level completed)






Allergies, Medical, & Special Needs:
(Leave Blank if None)
*Emergency Contact Name (1):
*Emergency Contact Phone (1):
(555-555-5555)
Emergency Contact Name (2):
Emergency Contact Phone (2):
(555-555-5555)
*Authorized Pickup #1:
Authorized Pickup #2:
Authorized Pickup #3:
Authorized Pickup #4:
Are you a member of this church?
If so, where?
May we have permission to photograph your child?
*T-Shirt Size:
Comments:
Parents...:
(Please let us know of anything specific about your child that we need to know to help meet their needs at VBS and make their time with us more enjoyable.)
Name and Age of Sibling(s) also attending:
First Track Option:
(We will do our best to accommodate track options although it is not guaranteed.)






2nd Track Option:






3rd Track Option:






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