WEEKLY STUDYVBS RegistrationSundayVBS RegistrtionVBS RegistrationEmergency Contact Information & Parental Consent FormThis form MUST be completed and turned into your child's leader as soon as possible for your child's safety. The signing of this form will cover all activities while your child participates in North Blendon VBS.Please enable JavaScript in your browser to complete this form.Child Name | Sex | Birthdate | Age *Grade Complete (Check One) *3&4 Year old/PreschoolYoung 5/ Kindergarten/ 1st2nd/ 3rd/ 4thT-Shirt Size (Check One) *2-46-810-1214-16Child Name | Sex | Birthdate | Age Grade Complete (Check One)3&4 Year old/PreschoolYoung 5/ Kindergarten/ 1st2nd/ 3rd/ 4thT-Shirt Size (Check One) 2-46-810-1214-16Child Name | Sex | Birthdate | Age Grade Complete (Check One) 3&4 Year old/PreschoolYoung 5/ Kindergarten/ 1st2nd/ 3rd/ 4thT-Shirt Size (Check One)2-46-810-1214-16Parent/Guardian *FirstLastPhone Number *Home Address *Number | Street | City | MI | Zip CodeFamily Doctor *Insurance Information *Please list any any physical limitations, medical allergies, dietary concerns, or special medical treatment procedures which this student may have or require. *Parent/Guardian Signature *In the event I cannot be reached in an emergency, I herby give permission to the physician selected by North Blendon Christian Reformed Church staff to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child as named above. In case of emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give the NBCRC staff permission to act on my behalf in seeking emergency treatment for my child in the event that such treatment is deemed necessary by the NBCRC staff. I/We do hereby give my/our child permission to attend and participate in the various activities and trips performed by the North Blendon CRC VBS. I also understand that in case of accident or injury to my/our child, North Blendon Christian Reformed Church will not be held liable.Submit