VBS Kids Registration Child's Name First Last Parent/Guardian Name First Last Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell PhoneHome PhoneEmail Age information (Check the following)* Preschool Prek Kindergarten 1st 2nd 3rd 4th 5th Select T-Shirt Size Small Medium Large XLarge 2XLarge If you would like to purchase a VBS t-shirt they will be $10 each.Do you attend Church anywhere? If so where?* May we have permission to photograph your child? Yes No May we have permission to use your child's photograph in church publications for the purpose of promotions (ex. VBS slide show)? Yes No Consent* I give permission....I do hereby give permission for my child to attend Mt Olive Baptist Church's VBS. I also grant Mt Olive Baptist Church to administer any first aid treatment that may be necessary in case of injury.