Register for VBS

Family Information

Address

Primary Phone

Alternate Phone

Relationship to Student Father Mother Grandfather Grandmother Great-grandfather Great-grandmother Brother Sister Uncle Aunt Guardian Foster Parent Granduncle Grandaunt Other

Phone Number

Student Information

Gender

Birth Date

Age Group

Food Allergies

Details

Medical Concerns

Details

Authorize King City—Emergency

I hereby authorize the staff and director of the KidzCity program at King City Church to give consent for any and all necessary emergency medical and first aid care for my above-mentioned child, while he/she is in King City Church's custody.

Authorize King City–Photo Release

I give permission for King City Church to take and share photographs or videos of my above-mentioned child. These will be shared with classroom families via private classroom communication means, and occasionally used for publicity purposes.

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