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Child's Name:
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Nickname/preferred name to be called:
Parent/Guardian Name:
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Address:
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Home Telephone:
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Child's Age:
Child's Date of Birth
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In case of emergency (when the parent/guardian cannot be reached), please contact:
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Relationship to child:
Please list any allergies/medical needs the VBS staff shuld be aware of:
Person responsible for picking up this child at the end of each VBS day
Name:
Telephone:
Tell us anything special you'd like us to know about your child:
Is this your child's first large-group experience other than Sunday school?:
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ONE friend your child would like to be with:
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334 14th Street
Del Mar, CA 92014
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