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Waynesboro Church of the BrethrenWaynesboro PA
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FOOD TRUCK PARTY:
On a Roll With God!
June 19th thru June 23rd, 2022
5:30PM - 8:30PM
Registration Form
Items marked with an
*
are required
*
Indicates required field
Child's Name
*
First
Last
Paren/Guardian Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Home Phone Number
*
Child's Birthdate
*
Cell Phone Number
*
Child's Age
*
Work Phone Number
*
Last Grade Completed in School
*
Home Church
*
Medical or other information we need to know. (Please include any food allergies.)
*
Emergency Contacts
Name 1
*
First
Last
Phone Number
*
Name 2
*
First
Last
Who may pick up your child at the end of each VBS session?
*
First
Last
Phone Number
*
Photography Permissions
Choose One
*
My child has permission to have their picture taken for both the craft project and to use any pictures taken for publication on the church's web pages.
My child has permission to have their picture taken for the craft project ONLY.
My child does not have permission to have their picture taken.
Name of Parent/Guardian completing this form
*
First
Last
You will receive an e-mail indicating that the form was submitted successfully.
Parent/Guardian Email
*
Submit