VBS Student/Youth Registration 2021 Name(Required) First Last Age(Required) School Grade Just Completed(Required) Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Parent/Guardian Name(Required) Street Address(Required) City(Required) Zip Code(Required) Parent/Guardian Cell Phone #(Required) A number we can contact in case of emergencyAlternate Parent Phone # Name of Another Adult to Contact in Case of Emergency(Required) Phone # of Alternate Adult(Required) How is Your Student Traveling to and From VBS?(Required) The Whole Family is Attending Parent or Authorized Adult will drop off/pick up Student is Driving Him(Her)self If You Selected "Parent/Adult will drop off/pick up," We Need the Name(s) of Those Whom Your Student Has Permission to Leave VBS With.(Required) If you selected any of the other two responses, you can simply write "N/A." Student's E-Mail Address(Required) Please Provide any Known Allergies, or Important Medical Info We Need to Know(Required)If there are no instructions needed, simply write "none"Are You a Member of a Church?(Required) Yes No If You Answered "Yes," What is the Name of the Church? We Will Be Taking Pictures and Video During VBS. Do We Have Permission to Post Images Containing Your Student to Our Church's Social Media Sites?(Required) Yes No Is There Any Other Information You Think We Should Know About Your Student?