Cornerstone Baptist Fellowship

Vacation Bible School


STUDENT PERSONAL INFORMATION Child`s First Name Child`s Last Name
Sex M F       Grade just completed
Birth Month 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 Zip

Emergency Contact 1 - Name Phone
Emergency Contact 2 - Name Phone

Does your family attend church? If so, where?


DISMISSAL PROCEDURE