VBS 2024 RegistrationPlease enable JavaScript in your browser to complete this form.Child's Name *FirstLastAge/Grade *3/4 Year Old (non-schooled)Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th GradeAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAdditional Child You may register multiple children on one form. Please complete a separate registration for kids not of the same household. Child's Full NameAge/Grade- None -3/4 Year Old (non-schooled)Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th GradeChild's Full NameAge/Grade- None -3/4 Year Old (non-schooled)Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th GradeChild's Full NameAge/Grade- None -3/4 Year Old (non-schooled)Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th GradeDoes your child/children need to ride the bus? *NoYesParent/Guardian NameFirstLastParent/Guardian Phone *Parent/Guardian EmailHow Will My Information Be Used? *Please check the box to agree.The information that you provide about you and your family will be used to plan for activities, food, and seating for VBS. Contact information is collected so that we may contact you in the case of an emergency.Consent *Please check the box to agree.I have read the information above and have had an opportunity to ask questions about the Waurika church of Christ's VBS program and how my information will be used. I understand the purpose of the VBS program and what my participation involves. I agree to allow my child/children to take part in the classes, games, activities, meals and for the information I provide to be shared with the Waurika church of Christ administrators and VBS staff, and this in turn allows services that I use to share information about me and my family for the purpose of this VBS program. I understand that I need to inform the other members of my family that I have given consent which will allow them to opt out if they wish. I understand that anonymized [information / research] about me and my family may be published within the [project report / relevant document], which may be published online and that published material from this [project / report] may be used and distributed for training and service design and development. I know that my participation is voluntary and that I can choose to withdraw from the activity at any point.Signature Clear Signature Date *Submit