Parents'/Legal Guardian's Names *

Enter both parents' names

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Secondary/Daytime Phone *

(in case of emergency)

(###)

###

####

How did you hear about Immanuel's VBS? *

Check all that apply

Banner

Church Bulletin/Newsletter

From a Friend/Family Member

Social Media

Postcard

Lawn Sign

Store Flyer/Poster

Newspaper/Media

Other

Photography Permission *

I give permission for the above child(ren) to be photographed at Immanuel’s VBS and have no objections to such photographs being used on Immanuel’s website or social media, in local print media or in promotional fliers. (Children’s names will not be included with photographs posted on Immanuel’s website or social media.)

Yes

No