GodSquad! Week 2017
Child’s Name (1)
*
Child 1 - Age, Date of Birth, Grade Entering (Fall 2017), Shirt Size
*
Child 2 - Name, Age, Date of Birth, Grade Entering (Fall 2017), Shirt Size
Child 3 - Name, Age, Date of Birth, Grade Entering (Fall 2017), Shirt Size
Child 4 - Name, Age, Date of Birth, Grade Entering (Fall 2017), Shirt Size
Child 5 - Name, Age, Date of Birth, Grade Entering (Fall 2017), Shirt Size
Caregiver’s Names (Mother, Father, Grandparent, etc.)
*
Mailing Address
*
Caregiver’s Preferred Phone Numbers (list two)
*
Caregiver’s Email Address
*
During VBS week, I would like to work as a volunteer.
No
Yes
Name(s) of interested volunteers.
Does your child have any special needs?
*
No
Yes
Does your child have any allergies?
*
No
Yes
Does your child need any medications?
*
No
Yes
Does your child have any dietary concerns?
*
No
Yes
If you answered yes to any of the above questions, please explain specific needs and indicate which child.
*
Emergency Contact Information (other than caregiver). Please list Name, Phone Number and Relationship to child.
*
Registration Fee: Includes GodSquad! T-Shirt
*
1 Child (Add $15.00)
2 Children (Add $30.00)
3 Children (Add $45.00)
4 Children (Add $60.00)
5 Children (Add $75.00)
After this form and payment is completed, you will be automatically directed to a Required Consent Form, which will complete registration.
Your Email Address
*
Total
$
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