LITTLE CYPRESS BAPTIST CHURCH

Vacation Bible School 2024

Little Cypress Baptist Church
July 22-26, 2024 6:00-8:30pm
For: Children 4 years old through grade 6

Student Registration Form

Child's Name

First Name

Last Name

Child's Age

Number Input

Birthdate

Child's Prior Grade

Grade

Parent/ Guardian Name(s)

First Name

Last Name

First Name

Last Name

Phone Number

Email

Emergency Information

Emergency Contact 1

First Name

Last Name

Phone Number

Emergency Contact 2

First Name

Last Name

Phone Number

Doctor

Text Input

Allergies

Special Needs

Text Area

Dismissal

Who may pick up your child at the end of VBS night

First Name

Last Name

First Name

Last Name

Single Choice

Choice One

Photo Release: I hereby grant permission for Little Cypress Baptist Church to take pictures or videos of the child being registered while on church property.
I also give permission to LCBC to use these images or videos in church print and online publication (including church websites and social media).

Signature

Vacation Bible School 2024

Student Registration Form

Emergency Information

Dismissal

About Us

Office hours

Contact info