Tampa Bay Presbyterian Church
June 23-27, 9:00 AM to 12:00 PM
*** Please submit one form for each individual child ***
Child's First & Last Name:
Child's Nickname:
Child's Birthday (MM/DD/YYYY): Child's Age as of 6/23/08:
Grade Completed:
Siblings attending VBS: (name and age)
Parent's First & Last Names:
Address:
City: State: Zip Code:
Parent's Home Phone: Mom's Cell: Dad's Cell:
Email Address:
Emergency Contact:
Relationship to Child:
Emergency Contact's Home Phone: Cell Phone:
People who can pick up Child:
Contact's Home Phone: Cell Phone:
How did you hear about VBS? TBPC NTCA Friend Other If Other, Please specify:
Food Allergies? No Yes (If Yes, list here):
Medical Concerns/Allergies? No Yes (If Yes, list here):
Special Instructions:
Church Affiliation: TBPC Other If Other, please name:
Check here if grant Tampa Bay Presbyterian church VBS Leaders permission to photograph/file the minor designated above in any manner or form for any lawful purpose associated with this VBS program.
Check here if you would like to receive email updates about other Children's Ministry events at Tampa Bay Presbyterian Church
