Please enable JavaScript in your browser to complete this form.Parent Information *FirstLastAddress *City *State *Zip Code *Email Address *Cell Phone Number *Other Phone NumberStudent Information *FirstLastNicknameGenderFemaleMaleDate of Birth *Last Grade CompletedAllergiesMedical Issues or Special NeedsHome Church(If Applicable)Photo Release *I hereby grant the above named church permission to copyright and use photographs/videos taken at VBS of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.Signature *Type your full name. This will be used as your signature.Submit