T-Shirt Paid: (CASH) (CHECK #__________)

NGBC - VBS 2019 Registration Formfor children who have completed 4k - 6th grade

Monday, June 10 - Friday, June 14, 8:00 a.m. - Noon

Child’s Name: _____________________________________________________________________________________

Parent/Guardian Name: ____________________________________________________________________________

Address: _________________________________________________________________________________________

Mailing Address (if different): ________________________________________________________________________

Phone Numbers

Home: ___________________________ Work: ___________________________ Cell: ___________________________

E–mail ___________________________________________________________________________________________

Age Information Last grade completed in school: __________________

Medical Information Medical or other information we need to know. (Please include any food allergies.) ________________________________________________________________________

________________________________________________________________________

Emergency Contacts Name: ______________________________________ Phone: ______________________

Name: ______________________________________ Phone: ______________________

Dismissal Information Who may pick up your child at the end of each VBS day?

________________________________________________________________________

How will your child be picked up? ______ Drive-up on Mercury St. (rear of church)

______ Walk-up on Grand Blvd. (front of church)

______ Ride bike or walk home (form on back)

Other Information Do you attend Sunday School? If so where? ________________________________________________________________________

Visiting NGBC? Who are you a guest of? ______________________________________

(NO) Children

May we have permission to photograph your child? (YES) (NO)

May we have permission to use your child’s photograph for the purpose of promotion? (YES)

Childresn are not allowed to possess a cell phone during VBS. Please initial that you understand:____

__________ VBS Participant's T-Shirt Size: (No T-Shirt) (YXS) (YS) (YM) (YL) (AS) (AM) (AL) (AXL) (T-shirts are for VBS participants and workers only.)

T-SHIRT PAYMENT IS REQUIRED DURING PRE-REGISTRATION. EACH SHIRT COSTS $10.

AFTER JUNE 7, THE COST OF T-SHIRTS WILL GO UP TO $15.

North Greenwood Baptist Church | 615 Grand Boulevard | Greenwood, MS 38930 | 662.453.2801

Mark your calendar!Family Night Wednesday,

June 12Bring $3 per person

for supper.

Annual VBS Program Sunday, June 16

during the 10:30am Worship Service.

Be sure to bring canned goods and loose change for our mission projects

each day!

Name of Child

VBS Bike Rider or Walker Waiver Date _____________

______________________ has permission to

________ ride his/her bike

________ walk

to this address _____________________________________.

I am the legal guardian of this child and give my permission.

Signature ___________________________

Print Name __________________________

Notary

Signature____________________________

Print Name___________________________

My commission expires_________________

seal