Vacation Bible School | Calvary Chapel SI

Child's Full Name *

Gender

Male
Female

Birthdate *

Last Grade Completed *

Address 1 *

Address 2

City

State

Zip / Post Code

Parent/Guardian *

Phone *

Email *

Relationship to Child *

Who can pick up your child? *

Name of home church (if applicable)

Does your child have any food allergies? *

Yes
No

If yes, please list all food allergies here:

Are there any medical concerns we should be aware of? *

Yes
No

If yes, please explain

Breakfast will be available from 8am-9am each morning. Please let us know if your child will be having breakfast.

I hereby grant permission for CALVARY CHAPEL to record sounds, images, or video of my child while attending this VBS program. I also give permission for CALVARY CHAPEL at its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by CALVARY CHAPEL in relation to this VBS program.

Yes, I grant permission
No, I do not wish to grant permission