VACATION BIBLE SCHOOL : Conyers Seventh-day Adventist Church Conyers GA

Child's Name

Child's Age

Child's Birth Date

Parent's (Guardian's) Name

Street Address

Parent's (Guardian's) Cell Phone Number

Parent's (Guardian's) Email Address

Is Someone Other Than the Aforementioned Parent/Guardian Arranged to Drop Off/Pick Up Your Child?

Yes No

If Yes, Please Put the First and Last Name of the Person Who Will Pick Up Your Child(ren).

What is Your Child's Religious Affiliation?

Please List Any Allergies/Other Medical Conditions Your Child Has:

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact Relationship to Child

I give the Conyers Seventh-day Adventist Church VBS Staff permission to call 911 in case of emergency.

Yes No

Photographs will be taken during VBS. I give permission for my child's photo to be taken and publicly shared on the digital and printed publications including social media, videos, and website of Conyers Seventh-day Adventist Church.

Yes No

Special Needs Survey

We are excited to have your child here at VBS! We believe that every child has God-given strengths and abilities. We would love to get to know your child better in order to encourage these strengths and abilities as well as to support them in the areas where they may need additional help. Please fill out the form below so we can get to know your child better.

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?

VBS Registration

Special Needs Survey