Geneseo Evangelical Free Church

2026 VBS Registration

Parent/Guardian First Name

Parent/Guardian Last Name

Phone Number

Email

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Emergency Contact First Name

Emergency Contact Last Name

Emergency Phone Number

Child First Name

Child Last Name

Gender

Birthdate

Grade entering this Fall

Allergies

Shirt Size

Are there other things for leaders to be aware of concerning your child?

Yes

No

What would you like leaders to know about your child?

Will you allow for any pictures or videos taken of your child(ren) to be used in general promotional material online or in print form for our church?

Yes

No

Please list first and last names of permitted adults who can drop off or pick up your child at Vacation Bible School.

Date Input

Signature