Your Child's Name (required)

Parent's/Guardian's Name (required)

Address (required)

Email Address (required)

Home Phone

Cell Phone

Work Phone

Age (required)

Birthday (required)

Last school grade completed(required)

Home Church

Allergies/Medical information

Name

Phone

Name

Phone

Name of person(s) who may pick up this child from VBS each day.

I give permission for Downsview Seventh-day Adventist Church to use my child's picture publicly

I will be willing to be a help during VBS?