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    Child's Full Name: (*) Age: (*) Grade Exited: (*) Address: (*) City: (*) ZipCode: (*) Does you child have medical needs or allergies? (*)

    Medical/Allergies: (Any info we may need to know!)

    Legal Guardian's Name: (*) Phone: (*) Relation to Child: (*)

    Other Relation: (*)

    I do hereby give permission for our (my) child to attend and participate in Vacation Bible School at Fundamental Baptist Church July 17-21, 2017. I also give permission for my child to participate in any and all activities at Fundamental Baptist Church, and to have their picture taken and published (on the church's Facebook and/or Website).
    Do you agree to these terms? (*)

    I'm sorry, but you must agree to the terms and sign the form to submit this registration!

    Guardian's Signature: (*)

    Date: (*)