Vacation Bible School 2010

at First Baptist Church, Tupelo

For More Information: Contact Rebecca Feather 842-1327

Child's Name
Parent/Guardian Name
Address
Mailing Address (if different)
Home Phone
Work Phone
Cell Phone
E-mail
Child's Birthdate
Child's Last grade completed
List any medical or other information we need to know. (Please include any food allergies)
Emergency Contact 1 Name
Emergency Contact 1 Phone
Emergency Contact 2 Name
Emergency Contact 2 Phone
Dismissal Info: Who may pick your child up from VBS?
Do you attend Sunday School? If so, where?
If you are visiting, who are you a guest of?
May we photograph your child?	Yes No
May we have permission to use your child’s photograph in church publications?	Yes No

Please answer the simple math question below to submit the form.

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