VBS 2021 REGISTRATION — Whispering Pines Baptist Church

REGISTER FOR MYSTER ISLAND - VBS 2021 AT WHISPERING PINES BAPTIST CHURCH

Child's Name

First Name

Last Name

Parents/Guardian

Address

Gender

Male

Female

Birthdate

YYYY

Grade Completed

First Name

Last Name

Work Phone

(###)

###

####

Cell Phone

(###)

###

####

Emergency Contact

First Name

Last Name

Relationship to Child

First Name

Last Name

Who can pick up your child?

Name of home church

List any food allergies

Medical Concerns

I hereby grant permissions for Whispering Pines Baptist Church to record sounds, images or videos of my child while attending THIS VBS program, and its sole discretion, to use these sounds, images, or videos in publications (including print, websites, and social media platforms) owned by Whispering Pines Baptist Church in relation to this VBS program.

My checking "Yes, I Agree" you are electronically signing this document

Whispering Pines Baptist Church

We are a body of believers who are committed to the faithful and clear instruction of the Scriptures, God's Word.