VBS Registration Form

June 20-24, 2011 – 9:00 a.m. to Noon

(Registration deadline:  June 6)

Child’s Name:    Age:

Date of Birth:   Completed ‘10-‘11 Grade:

VBS buddy request:

Name(s): 

Address:      

Home phone:

Cell phone (if different than home#):

E-mail:

Home Church:

Emergency Contact:

Relationship:

Phone:

Allergy/Special Needs:

Media Release

 I authorize Oxboro Evangelical Free Church to use photos or videos taken of myself or my family members at church for promotional puposes. At no time will photos be used by unrelated organizations.

(Please check box to indicate permission)