Register for VBS

Family Information

Address

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

I hereby authorize Sempronius Baptist Church staff or volunteers to take and/or use images or likenesses of me or my child(ren), including photographs, videos or otherwise, for any lawful use on the ministry's website, social media pages, or in other official ministry printed or electronic publications without further consideration. Permission to Photograph

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Student Information

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Birth Date

Age Group

Food Allergies

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Medical Concerns

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