VBS Registration Form All items are required. Child’s Name: Parent/Guardian Name: Street address, city, state, and zip code): Mailing Address (if different): Home Phone: Work Phone: Cell Phone: Email Address: Age Information Birth Date: Last Grade Completed in School: Medical Information Medical or other information we need to know (Please include any food allergies): Emergency Contacts (at least one name and phone number required): Name: Phone: Name: Phone: Dismissal Information Who may pick up your child at the end of each VBS day? Other Information Do you attend Sunday School? If so, where? May we have permission to photograph your child? Yes No May we have permission to use your child’s photograph for the purpose of promotion? Yes No Next Car Rider Registration (Car Rider # and Class to be completed by Registrar) Car Rider # __ Who is allowed to pick up your child/children? Adult Phone Number Adult Phone Number Children to be picked up: Child Grade Completed Class ___ Child Grade Completed Class ___ Child Grade Completed Class ___ Child Grade Completed Class ___ Child Grade Completed Class ___ Child Grade Completed Class ___ Next Car Rider Pick Up Procedures for Parents The car rider tag needs to be displayed on the passenger side of the windshield. If there is a change in who will pick up a child/children, it is the responsibility of the parent/guardian to give the authorized person the “Car Rider” tag. If a tag is not displayed, the driver will be asked to pull over to a “hold” line to have the pick up authorized. You may call 936-661-9067 before 11:30 a.m. if there is a change in pick up or if a child/children will be picked up early. Please enter the church parking lot from Fisher Street. For the safety of all children, please remain in your car and follow the instructions of the parking lot attendants. NO CHILD/CHILDREN WILL BE RELEASED WITHOUT THE “CAR RIDER” TAG, WRIST BAND, OR VERIFICATION OF A CHANGE. I verify that I have read and agree to the Car Rider Procedures.