Glory Church VBS 2024 Sign Up

Child's Information

Child's Name

Gender

Age

Last Grade Completed

Grade

I understand that the nursery is for VBS workers, and Adult class attendees

Yes

No

Food Allergies

Any food allergy? If yes specify below

Yes

No

Allergies

Emergency Contact Info

Parent/Guardian

Email

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Can anyone else pick-up your child?

Yes

No

Name of Pick-Up Person

Photo Consent

May your child have their picture taken?

Yes

No

I hereby grant all rights to Glory Church at Dante (“Church”) to use my photograph and/or other reproduction of me or my physical likeness for Glory Church publication purposes, whether electronic, print, video, digital or electronic publishing via the Internet. I acknowledge Church’s right to crop or treat my photograph(s) at its discretion. I also acknowledge that Church may choose not to use my photo at this time, but may do so at its own discretion at a later date.