VBS 2022 Jasper Canyon Registration : Rialto SDA Church Rialto CA

>Home >Trashed >VBS 2022 Jasper Canyon Registration

VBS 2022 Jasper Canyon Registration

Child's Name

Child's Date of Birth

Child's Age

Name of Parents/Guardians

Address

Parents/Guardians Cell Phone Number

Parents/Guardians Email Address

Custodial arrangement if applicable:

Allergies or other medical conditions (i.e. diabetes):

In case of emergency, contact:

Emergency Contact Phone Number

Emergency Contact Relationship to child:

I give permission to call 911 in case of emergency.

Photographs will be taken during VBS. My signature indicates I am giving permission for my child’s photo to be taken. Parenct/guardian signature

My child has the following educational label or medical diagnosis

My child’s primary means of communication is:

Additional information concerning my child’s allergies or food sensitivities:_

My child’s favorite activities and interests are:

My child avoids doing or becomes easily frustrated with the following activities:

If my child becomes overwhelmed or frustrated they will respond best to:

My child’s strengths are

My child needs help with:

What suggestions do you have that may help us create the best possible experience for your child?

What information would you like us to share with other children at VBS that will help them to better know, accept and understand your child?