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Contacts in Case of Emergency:
VBS Child Registration (June 16-20, 2008)
Parent's Information:
Registration deadline is Monday, June 2nd!
First
Birthday (mm/dd/yyyy):
Grade (Entering in Fall 2008):
Gender:
Gender:
Grade (Entering in Fall 2008):
Birthday (mm/dd/yyyy):
Name:
Name:
Grade (Entering in Fall 2008):
Birthday (mm/dd/yyyy):
Gender:
Name:
Grade (Entering in Fall 2008):
Birthday (mm/dd/yyyy):
Gender:
Children Attending:
Email:
Zip:
State:
Address:
City:
Phone:
Name:
Please list any special considerations (allergies, medical, placement with a non-CGS friend, etc.):
Name:
Phone:
Relationship:
Name:
Phone:
Relationship:
IN CASE PARENTS OR EMERGENCY CONTACT PERSONS IDENTIFIED ABOVE CANNOT BE REACHED, I HEREBY AUTHORIZE THE STAFF OF THE CHURCH OF THE GOOD SHEPHERD VBS TO SEEK EMERGENCY CARE FOR MY CHILD, INCLUDING HOSPITAL EMERGENCY ROOM SERVICES.
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