VBS 2018  -  Shipwrecked
June 10         5:00 -8:30pm
June 11-13    5:30-8:30pm
 
 
Participant First & Last Name
 *
Gender
 *
Grade Entering/Age
 *
Is Participant potty trained? *I
 *
*If No, FOTH staff are not responsible for diaper changes. Parent is welcome to stay and accompany child.
Participant Shirt Size
 *
Parent First & Last Name
 *
Parent/Emergency Contact Phone #
 *
Secondary Emergency Contact Phone #
 *
Parent Address:
 *
Parent Email
 
Does Participant have any allergies?
 *
If so, please specify allergy and instruction for FOTH to follow in case of an emergency
 *
Please list any medical issues/information:
 *
Will the parent be picking up participant?
 *
Alternate Pick-up Name & Phone #
 *
Alternate 2 pick-up Name & Phone #
 *
Any additional information and comments
 
Verification Code:
Insert above code:
 * Required


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