Jersey Shore Calvary Chapel
Vacation Bible School Registration

Child's Information

Child's Name:

Allergies / Special Needs

Child's Age

Birth Date

Child's Grade

Child's Shirt Size

Parent / Guardian Information

Parent / Guardian Name

Parent / Guardian Email

Parent / Guardian Phone

Phone Type

Home

Cell

Parent/Guardian 2 Name (Not Required)

Parent/Guardian 2 Contact Phone (Not Required)

Emergency Contact Information

Emergency Contact 1

Emergency Contact 1 Phone Number

Emergency Contact 2

Emergency Contact 2 Phone Number

Doctor

Child's Doctors Phone Number

Dismissal

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

Photo ID REQUIRED.

Pick Up Person 1 Name

Relationship

Pick Up Person 2 Name (Not Required)

Relationship (Not Required)

Photo & Video Consent

During Jersey Shore Calvary Chapel's (JSCC) Vacation Bible School (VBS), JSCC will be taking photographs and videos of the children and volunteers to document the events of each day which may be posted on JSCC's Social Media sites (ex. Facebook) or used in Church presentation. If you do NOT want JSCC to photograph your child, please check below box.

JSCC may use photos of my child to document VBS on Social Media or in Church presentation.

Yes

No

Parent/Guardian Signature