Child's Name * First Name Last Name Child's Date of Birth * MM DD YYYY Grade Completed * PRE-K KINDERGARTEN 1ST 2ND 3RD 4TH 5TH Does your child have any allergies we need to be aware of? * YES NO Please list allergies: Parent Name * First Name Last Name Parent Phone Number * (###) ### #### Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Authorized Pick-Up Person #1 * For the safety of your child(ren) we will only permit the adults named on your registration form to pick up your child from Backyard Bible Camp. First Name Last Name Authorized Pick-Up Person #2 First Name Last Name T-shirt Size Youth XS Youth Small Youth Medium Youth Large Adult Small Adult Medium Do we have your permission to photograph your child during VBS? * YES NO Do you attend a local church? * YES NO Thank you for registering for thisyear’s Backyard Bible Camp (VBS). We can’t wait to see you for Camp Firelight!
