Vacation Bible School Student Registration Child's Name Gender Gender Boy Girl Child's Birthdate School Grade Entering Fall 2018 (Colors after each grade are the T-shirt colors.) School Grade Entering Fall 2018 (Colors after each grade are the T-shirt colors.) Pre-K (orange) Kindergarten (green) Grade 1 (girls yellow, boys royal blue) Grade 2 (girls yellow, boys royal blue) Grade 3 (girls purple, boys navy blue) Grade 4 (girls pink, boys red) Grade 5 (girls pink, boys red) Parent(s) Name Street Address City State ZIP Email Address Emergency Contact Number Permission to use child's image on website or newsletter? Permission to use child's image on website or newsletter? Yes No Permission for child to participate in water activities? Permission for child to participate in water activities? Yes No Child's Allergies or Other Medical Conditions (or enter 'None') Home Church (or 'None') I certify that I am the child's parent/guardian and that I completed this form. I certify that I am the child's parent/guardian and that I completed this form. Yes No 5 + 9 = Submit