Cornerstone Baptist Fellowship
Vacation Bible School
STUDENT PERSONAL INFORMATION
Child`s First Name
Child`s Last Name
Sex
M
F Grade just completed
Pre-School
Kindergarten
!st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Birth Month
January
February
March
April
May
June
July
August
September
October
November
December
Birth Date
Birth Year
ANY FOOD ALLERGIES AND/OR MEDICAL CONDITIONS WE SHOULD KNOW ABOUT?
Yes
No
If YES, please describe here
Yes
No My child will be eating supper at VBS.
Yes
No I give permission for Cornerstone to photograph my child for
Security Purposes
and
Internal Use
only (Internal Use = Record Keeping, Church Bulletin Boards, Sunday Morning Slideshows).
FAMILY INFORMATION
First Name
Last Name
Phone Numbers - Primary
Secondary
Email
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
Emergency Contact 1 - Name
Phone
Emergency Contact 2 - Name
Phone
Does your family attend church? If so, where?
DISMISSAL PROCEDURE
At dismissal your child will be:
Walking?
Biking?
Picked Up?
The Security Team will set up a clearly marked area designated for child BEING picked-up.
You will be given a card at child drop-off; you must show this card at the end of VBS to pick-up your child.
Who, beside yourself, may pick up your child at the end of VBS each day?
Signature