VBS Magnified 2025 June 8-11 @ 5:15 PM (Free Family Dinner each evening)

Parent/Caregiver Information:

YOUR FIRST/LAST Name

YOUR Email

This address will receive a confirmation email

YOUR CELL Phone

YOUR Address

Child #1 Information:

Child #1's FIRST/LAST Name:

Your relationship to Child #1: Please check one

Parent Grandparent Caregiver/Foster Parent Aunt/Uncle Other

Child #1's Birthdate:

Last Grade Completed:

Any Known Allergies? If so, please list...

Medical Information: Medical or Other Info we need to know. ( Please include any special needs if applicable)

Any dietary restrictions? If so, please list...

Do you regularly attend church somewhere w/ your child/children? If so, please list below.

Did your child/children attend VBS @ HBC last summer ( 2024)? Yes No

Child's T-Shirt Size Youth XS Youth S Youth M Youth L Adult S Adult M

Address IF different than parent/caregiver's above:

Emergency Contact Information:
(Only need to complete once for multiple children)
*This person has my permission to
pick up my child/children after VBS and/or contacted in the event of a true emergency when I cannot be reached.

1. Name of ER Contact:

Phone

2. Name of ER Contact:

Phone:

Photography Consent:

May we have permission to photgraph your child/children? Photos may be used on Hopewell Baptist Church's social media outlets only. Please check Yes or No.

Yes No

Digital Signature for Photo Permission: ( Type Parent's/Guardian's Name)

Text from HBC Consent:

I am ok with receiving minimal texts from Hopewell Baptis Church...Please check Y or N

Yes No

PLEASE ADD ANY ADDITIONAL CHILDREN
BELOW UNDER EACH HEADING.
When registration is complete...
SCROLL TO BOTTOM of FORM to hit SUBMIT!

Child #2 Information:

Child #2's FIRST/LAST

Your relationship to Child #2: Please check one Parent Grandparent Caregiver/Foster Parent Aunt/Uncle Other

Child #2's Birthdate:

Last Grade Completed:

Any Known Allergies? If so, please list...

Medical Information: Medical or Other Info we need to know. ( Please include any special needs if applicable)

Any dietary restrictions? If so, please list...

Has he/she attended VBS @ HBC in the past? Yes No

Child's T-Shirt Size Youth XS Youth S Youth M Youth L Adult S Adult M

Address if different than Parent/Caregiver:

Child #3 Information:

Child #3's FIRST/LAST Name:

Your relationship to Child #3: Please check one Parent Grandparent Caregiver/Foster Parent Aunt/Uncle Other

Child #3's Birthdate:

Last Grade Completed:

Any known allergies? If so, please list...

Medical Information: Medical or Other Info we need to know. ( Please include any special needs if applicable)

Any dietary restrictions? If so, please list...

Has he/she attended VBS @ HBC in the past? Yes No

Child's T-Shirt Size Youth XS Youth S Youth M Youth L Adult S Adult M

Address if different than Parent/Caregiver:

Child #4 Information:

Child #4's FIRST/LAST Name:

Your relationship to Child #4: Please check one Parent Grandparent Caregiver/Foster Parent Aunt/Uncle Other

Child #4's Birthdate:

Last Grade Completed:

Any known allergies? If so, please list...

Medical Information: Medical or Other Info we need to know. ( Please include any special needs if applicable)

Any dietary restrictions? If so, please list...

Has he/she attended VBS @ HBC in the past? Yes No

Child's T-Shirt Size Youth XS Youth S Youth M Youth L Adult S Adult M

Address if different than Parent/Caregiver:

VBS Magnified 2025 June 8-11 @ 5:15 PM (Free Family Dinner each evening)

Description

Please Fix the Following