| Thank you for registering for Canton First Baptist Backyard VBS 2021! We are excited that you will be joining us June 14th-16th at the location you have chosen. Each day you will meet for a time of music, bible lesson, crafts, refreshments, recreation and more! We look forward to having you join us. See you at the Backyard VBS this summer! Pastor Keith |
| *Participant's First Name: |
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| *Participant's Last Name: |
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| *Birthday: |
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| *Last Grade Completed: |
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| *Parent/Guardian Name: |
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| *Address: |
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| *City: |
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| *State: |
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| *Zip: |
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| Cell Phone: |
(______)______-________ |
| Home Phone: |
(______)______-________ |
| Email: |
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| *I would like for the host home to contact before start date.: |
Yes
No (circle one) |
| *I will be attending Backyard VBS at this location:: |
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| Parent location during VBS: |
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| *Emergency Contact Name (1): |
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| *Emergency Contact Phone (1): |
(______)______-________ |
| Emergency Contact Name (2): |
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| Emergency Contact Phone (2): |
(______)______-________ |
| Allergies, Medical, & Special Needs: |
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| *Authorized Pickup #1: |
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| Authorized Pickup #2: |
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| Do you attend Church?: |
Yes No (circle one) |
| If so, where?: |
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| May we have permission to photograph your child?: |
Yes No (circle one) |
| May we have permission to use your child's photograph in church publications?: |
Yes No (circle one) |
| Comments: |
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