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Participant Registration

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Longview Heights Baptist Church Four Friends Ministry

Location

4501 Goodman Road

Olive Branch, MS 38654

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Contact Lisa Wilson:

662-895-1900

lwilson@lhbc.me

First, Tell Us About Yourself:

Parent Information

PLEASE NOTE: Four Friends Special Needs VBS focuses on our special needs friends. To accomplish this we ask that you only register your child with special needs. We are not able to accommodate siblings for this event. Thank you for your understanding.

** Please NOTE: This first section is for PARENT/GUARDIAN information. You will enter your child's information afterwards.

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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Comments

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Does your family attend a local church

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If yes, what church do you attend?

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Continue scrolling below to complete PARTICIPANT REGISTRATION.

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

First Name

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Last Name

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Please note: Please choose the last grade completed below or choose ADULT for those out of school.

Grade Leaving

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Gender

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Date Of Birth

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Allergies

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Medical Concerns

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Comments

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Please give a brief description of your child's diagnosis.

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Share with us any useful information that will help our volunteers make your child's experience successful (likes, dislikes, fears, comfort items, etc).

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Does your child have any food restrictions?

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Toileting Needs:

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Will medication need to be administered during VBS?

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Information release: I understand that the information shared on this registration form will be shared with my child's VBS leader and rotation leaders. The sharing of this information is to help us meet their needs and allow them to have a successful experience at VBS.

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Photo & Video Release: I understand that by allowing my child to participate in this event, that he/she may be photographed and/or videotaped during activities and these photos/videos may be used in promotional materials or media.

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T-Shirts - We will not be taking pre-orders for VBS shirts this year. Shirts will be available on a first come, first served basis at VBS. Cost is $10