VBS Registration Please complete a separate form for each child attending VBS.VBS Registration 2019VBS Registration 2019Child's Name*Last name, first nameBirth Date*MM/DD/YYYYAge*Address*Number & Street NameAptApartment Number if appropriateCity*Zip Code*Grade Completed*Grade completed as of end of school year.Gender* Male FemaleMother's Name*Mother's Cell#*Mother's email*Father's Name*Father's Cell#*Father's email*My child has permission to leave withProvide: Name, relationship, and phone number if different from mother or father.Does child have any allergies?* No YesIf answered Yes above - List allergies*Medical InformationList any conditions that staff may need to be aware of to ensure the safety and well being of your child.Authorization for Release* Yes NoAs a parent or guardian, I give permission for my child's picture to be taken while participating in activities at Westway Baptist Church. By checking Yes, I also authorize their pictures to be published to Westway's web page.Date Submited*MM/DD/YYYYSubmit Registration