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Participant Registration

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Registro en Español

The Village Church

Location

4229 Pacetti Road

Saint Augustine, FL 32092

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Contact Grace Smith:

904-466-3699

seedsandloaves.ministry@gmail.com

First, Tell Us About Yourself:

Parent Information

REGISTRATION IS ONLY OPEN TO FAMILIES WHO ATTEND THE VILLAGE CHURCH AT THUS TIME

Please complete all Sections of this form. If your child is not in school yet but is potty-trained, please register them as Pre-K. Note: only those listed on this form as a parent/guardian or alternate pickup will be allowed to pick your child up.

First Name

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Last Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Alternate Pickup Name

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Alternate Pickup Phone

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Alternate Pickup 2 Name

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Alternate Pickup 2 Phone

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Home Church Affiliation

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How did you hear about this event?

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

Complete the registration below for your child/children. Note: Students entering 6th grade should register as a volunteer.

Has your family attended VBS at The Village Church or through Seeds & Loaves before? (Registration is open to members of TVC on March 2nd, returning VBS families on March 23rd, and the public on March 30th)

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First Name

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Last Name

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Grade Entering

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Gender

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Date Of Birth

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Shirt Size

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Allergies

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Medical Concerns

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Will your child need a 1-on-1 buddy? (Typically for children with developmental or behavioral differences)

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If yes, how can a buddy best serve and benefit your child?

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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How can we be praying for your family?

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Comments

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