Vacation Bible School at Christ the King

Family Information

Parent/Guardian Name 1

Parent/Guardian Cell phone 1

Parent/Guardian Email 1

This address will receive a confirmation email

Parent/Guardian Name 2

Parent/Guardian Cell Phone 2

Parent/Guardian email 2

Address

Will anyone else bring or pick up your child(ren) (grandparents, etc.)? List them here.

Student Information

Child's Name

Date of Birth

Current Age

Please share any allergies, medical conditions, or special needs we should be aware of so we can care for your child safely and well.

Child's Name

Date of Birth

Current Age

Please share any allergies, medical conditions, or special needs we should be aware of so we can care for your child safely and well.

Child's Name

Date of Birth

Current Age

Please share any allergies, medical conditions, or special needs we should be aware of so we can care for your child safely and well.

Child's name

Date of Birth

Current Age

Please share any allergies, medical conditions, or special needs we should be aware of so we can care for your child safely and well.

Emergency Contact Information

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship

Photo Release

At Christ the King, we love celebrating what God is doing in the lives of our church family. From time to time, we capture photos and videos during our services and events to share these special moments with others.

By checking yes below, I give permission for my child to be photographed and/or recorded during church activities. I understand these images may be used by Christ the King on social media, our website, and other church communications to encourage others and share what God is doing in our community.

We are committed to using all images respectfully and appropriately.

I have read the statement above and agree to allow Christ the King Lutheran Church to use photos and/or videos for the purposes mentioned above.

Yes No

Signature

By checking this box, I am indicating that the above information is accurate.

Electronic Signature*

*By entering my name in the box above, I am providing my digital signature on this Form.

Vacation Bible School at Christ the King

Description

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