RELENTLESS VBS REGISTRATION MAY 20-23, 2019 (Registration deadline May 17, 2019)

RELENTLESS VBS 2019 May 20-23 | Please fill out this form and click submit. GRC members, if your child's BREEZE information is updated, you simply need to submit your child's name to register. (Use form on the left.)

Child's Name

*

Child's Age

*

Child's Grade

*

Child's School

*

Does your child have any allergies or medical issues? Please note below.

*

Parent Name

*

Parent Contact #

*

Address

*

Email

*

This address will receive a confirmation email

Emergency Contact Name and Number

*

TSHIRT SIZE

*

Please select one option.

YOUTH SMALL YOUTH M YOUTH L YOUTH XL ADULT SM ADULT M ADULT L

Name of Individuals who have permission to pick up your child

*

I give authorization to Grace Ridge Church to photograph and release such photographs of my child for the purpose of public information and publicity in the interest of the church.

*

Please select all that apply.

Yes No

I give permission for my child to ride the bus from the following school

*

Please select all that apply.

STOURBRIDGE LAKESIDE DAMASCUS CHILD BEING DROPPED OFF

Description

RELENTLESS VBS 2019 May 20-23

Please fill out this form and click submit. GRC members, if your child's BREEZE information is updated, you simply need to submit your child's name to register. (Use form on the left.)

Please Fix the Following

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