VBS – Cave Quest Registration Form

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CAVE QUEST VBS REGISTRATION FORM

(One per family)

July 11 – 15, 2016

Visitation Parish Church

9:00am – 3pm

Includes Lunch and Snack

        *Please bring a hat, sunscreen, and running shoes.

 

Child’s Name                        Age        Birth Date dd/mm/yyyy     Entering Into Grade:

 

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Parents/ Legal Guardian’s Names:           __________________________________________________________________________________________________________________________________

Home Phone #:                                                                                                               

Cell Phone #:                                                                                    

Work Phone #:                                                                                                                                                                                                                

Home  Address:                                                                                                                    ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Will you need an early drop off or late pickup?

Early (7:30am)      ⃝                Late (5:00pm)       ⃝

Emergency Contact:                                                                                                        

Phone #:                                                                           

 Name(s) of people other than yourselves that you give permission to take your children home:                                              __________________________________________________________________________________________________________________________________

Food Allergies or Medical Concerns (if your child has an epi-pen, please provide the appropriate form granting staff permission to administer the medication):_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Family Church:                                                                                                    City:                                                                                                   

I hereby grant permission the minor(s) designated above to participate in the 2016 Cave Quest VBS at Visitation Parish.  In addition I grand the Cave Quest VBS leaders permission to photograph the minor(s) designated above in any manner or form for any lawful purpose associated with the VBS program. This does not grant said leaders the right to publically publish the names of said minor(s).

 

Parent/Legal Guardian’s Signature:                                                                                                         Date: