Vacation Bible School

August 3rd-5th, 6pm-8pm

Parent's First and Last Name

Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Child's name and age in attendance

Are there any allergies for any of the children? Please let us know who and what

Will the parent be attending or dropping off?

Attending

Dropping off

Emergency number and contact for the child or children

Are there any other specific instructions we need to have or know about?

Please read the disclaimer below and sign

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

I understand that this information is not going to be sold to any third parties will be used exclusively for the purposes of vacation Bible School related things, such as follow up calls, and texts. I understand that none of the staff of Eagle River Baptist Church, nor any of its volunteers are medically trained and reserves the right to contact emergency services should it become necessary to save the life of my child. Eagle River Baptist Church is a non-profit organization 501 (c) (3).