VBS REGISTRATION

Child's First and Last Name*

Date of Birth and Last Grade Completed (must be 3yrs old as of 09.01.24)*

Name of Parent or Guardian (include relationship to child)*

Parent/Guardian Phone*

Email*

Address*

Emergency Contact Name and Phone Number (other than listed above)*

Dismissal Information - Who can pick up your child at the end of VBS?*

Does your child attend Sunday School? (Y/N) If not, we invite your family to visit us Sunday at 9:15 AM for Group Study and 10:30 AM for Worship.*

Does your child need transportation? (Y/N)*

Permission to photograph your child for use in video for parents/family? (Y or N)*

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Peniel Baptist Church 5227 Silver Lake Drive Palatka, FL 32177 US

Vacation Bible School 2025 - MAGNIFIED!