Register for VBS

Family Information

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

Address

Primary Phone

Alternate Phone

Emergency Contact

Phone Number

2nd Emergency Contact Number

Church Affiliation

Do you have a home church? ------ Yes No

Would you like more information about Seneca Baptist ------ Yes No Maybe

Will you be attending the Adult Class? If so, please indicate the names of all attending.

Student Information

Gender

Birth Date

Please select the grade your child will be heading into:

Age Group

Medical Information (please check the box if it applies)

Food Allergies

Details

Food Intolerance

Medical Concerns

Details

Please let us know of any additional medical information or concerns your child has. If he or she carries an epipen or inhaler, please let us know where it will be located.

Please indicate any other concerns you would like us to know (i.e learning disabilities, if your child does not like to read out loud, anything you think is important). This will be shared only as N2K

Transportation

Please indicate on how your child will be arriving and leaving Vacation Bible School

How will your child be arriving to VBS ------ Car Rider arrival VBS SBC Bus arrival VBS

How will your child be leaving to VBS ------ Car Rider Leaving VBS SBC Bus Leaving VBS

List any pickup concerns regarding your child

Address for Pickup/ Drop off if child is riding an SBC Bus

Additional Comments

Do you have any questions or comments? (Please list any information that you think we should know about your child here.)

Photo Sharing Permission

SBC takes photos and videos of VBS throughout the week and compile them into an "End of VBS Video". These photos and video of your child will not be posted on the internet w/o permission.

Is Seneca Baptist Church allowed to share a photo of your child anywhere on the internet? Yes No

Water Day Permission Slip

Thursday, July 17th, 2025 or Friday, July 18th, 2025

has my permission to participate in water activities on July 17, 2025 or July 18, 2025 at Seneca Baptist Church.

Date ____/____/_____

Thanks! Seneca Baptist Church

I have more students to register