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Registracion del Participante

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First Baptist Church Vincent

Location

15 Waite St

Vincent, AL 35178

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Contact Chelsea Latimer:

205-672-2512

assistant@fbcvincent.org

Primero, cuéntenos sobre usted:

Información de los Padres

Nombre

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Apellido

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Dirección 1

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Ciudad

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Estado/Provincia

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ZIP/Código Postal

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Correo Electrónico

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Home Church

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Teléfono de Contacto 1

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Teléfono de Contacto 2

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Nombre del Contacto de Emergencia

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Teléfono del Contacto de Emergencia

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Nombre de recogida alternativo

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Teléfono de recogida alternativa

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Cuéntanos sobre tu participante

Children who will be 5 yrs old by Sept. 2 through those leaving 5th grade will register as a Participant. Youth will register as a Helper. Helpers may participate in all VBS activities, but they will have assigned duties. (No Cell Phones Please)

Are you registering as a Participant OR as a Helper?

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Nombre

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Apellido

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Fecha de nacimiento

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Grado Saliendo

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Género

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Alergias

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Preocupaciones Médicas

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¿Tienes amigos con los que te gustaría estar juntos? Haremos todo lo posible para juntar a los amigos seleccionados en el mismo grupo, pero no podemos prometer que todas las solicitudes serán posibles.

Amigo 1 Nombre

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Amigo 1 Apellido

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Amigo 2 Nombre

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Amigo 2 Apellido

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Amigo 3 Nombre

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Amigo 3 Apellido

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OK to include my child in photos/videos on Church Facebook page or Worship Service? Yes/No

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Comentarios

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Parent's Signature - Date

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