Child's Name *

Last Grade Completed *

Date of birth *

Medical or other Information we need to know

List any Food Allergies or any other allergies

Parent/Guardian Name *

Relationship to the Child *

Phone *

Address

Street Address *

City *

State *

Country

Postal Code *

Email *

Emergency Contact 1 (name and Phone number) *

Emergency Contact 2 (Name and Phone number) *

Who may pick up your child at the end of VBS each day? *

Does your child attend church somewhere? If so, where?

May we have permission to photograph your child? *

Yes

No

May we have permission to use your child's photograph for the purpose of promotion? *

Yes

No

How did you hear about our VBS?

By checking this box, I consent to receive non-marketing text messages and emails from Meadowbrook Baptist Church. Message frequency varies, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

Please Sign acknowledging the above information is true and you give permission for your child to attend Meadowbrook Baptist Church's VBS 2026. *

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