Sinking Creek Baptist Church

Child's Name

Birthdate

Last Completed Grade in School

Allergies / Other Medical Information

T-Shirt Size

Parent / Guardian's First Name

Last Name

Email

Primary Phone Number

Secondary Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Emergency Contact's (Other than those listed above)

Emergency Contact 1's Name

Emergency Contact 1

Emergency Contact 2's Name

Emergency Contact 2

Who May Pick Up Your Child From VBS

Does Your Child Attend Church

Yes

No

Where does your child attend church?

If your child is visiting our church, who is he/she a guest of?

May we photograph your child?

Yes

No

If yes, May we use the photograph in promotional videos / stills.

Yes

No

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