Twists & Turns VBS

June 12-16,

9-11:30 am

Ages 4-12

Registration Form

Child's Name *

First

Last

Gender *

Male
Female

Birthdate *

Grade Completed *

Address *

City *

State *

Parent/Guardian *

Email *

Phone Number *

Emergency Contact *

Relationship to Child *

Who can pick up your child? *

Phone Number *

Name of home church

Food Allergies *

Please list food allergies

Medical concerns *

Please list medical concerns

Child's Name *

I hereby grant permission for First Baptist Church Rochester to record sounds, images, or video of my child while attending this VBS program. I also grant permission for First Baptist Church Rochester at its sole discretion, to use these sounds, images, or video in publications (including print, website and social media platforms) owned by First Baptist Church Rochester in relation to this VBS program.

Parent/Guardian Signature *

Date *