Event Registration

Register for VBS by filling out the information below. Please complete a separate form for each child:

Child's info:

First Name

Last Name

Age

Child's Birthdate

Grade Completed when VBS begins

Parent/Guardian info:

Parent/Guardian Name

Email Address

Home Phone Number

Cell Phone Number

Home Church

Please enter your full address:

Street Address

City

Zip Code

For your child's safety:

Emergency Contact - Name & Relationship to Child

Emergency Contact - Phone Number

Allergies / Medical Information

Please let us know if someone other than yourself will be picking up your child. Note: they will have to provide their driver's license as identification

Are there any individuals who are restricted from having contact with your children?

Yes

Permission to use your child's image in a slide show, shown to the kids on the last day of VBS

Yes

I'd like to receive emails about children's programs and upcoming events at Trinity (your email is not shared with any outside party; we respect your privacy)

Yes

My child has permission to attend and participate in the VBS program at Trinity Baptist Church, Fairfield CT

Yes

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