VBS Registration Form – Downsview Seventh-day Adventist Church

STUDENT INFORMATION

Name*

M.I.

Birth Date

Gender

Have you previously attended VBS?

Yes No

Home Church (if any)

Address

Primary Phone Number

Secondary Phone Number

Siblings Enrolled in VBS

EMERGENCY CONTACTS

Please list the first and last names and phone numbers off ALL adults who are allowed to pick up this child. The child will only be released to these people.

Primary Guardian *

Relationship To Child

Phone Number

Alternate Guardian *

Relationship To Child

Phone Number

Medical Infromation

Please list all allergies -- or type "none" if there are none

Does your child carry an epi-pen? (please note: if yes, it is the responsibilty of the child's guardian to ensure the child has the epi-pen at every drop off and pick up)

Yes No

Please list all medical concerns -- or type "none" if there are none

Additional Information

VBS photos/videos are taken for promotional purposes related to Downsview S.D.A Children's Ministry and Vacation Bible School. These pictures appear in various media outlets such as our facebook/instagram page and webpage. Will you allow your child to be included in these photos/videos?

Yes No

Acceptance

By submitting this form, I ackowledge I have read and understand the above information.

Service Times

Our Location

Contact

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