Child 1 Name *

First Name

Last Name

Child 1 Age *

3 years old

4 years old

5 years old

Kindergarten Completed

1st Grade Completed

2nd Grade Completed

3rd Grade Completed

4th Grade Completed

5th Grade Completed

Child 1 T-Shirt Size *

XS

S

M

L

XL

Parent's Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Phone *

(###)

###

####

Secondary Phone

(###)

###

####

Contact Name *

First Name

Last Name

Phone *

(###)

###

####

Child 2 Name

First Name

Last Name

Child 2 Age

3 years old

4 years old

5 years old

Kindergarten Completed

1st Grade Completed

2nd Grade Completed

3rd Grade Completed

4th Grade Completed

5th Grade Completed

Child 2 T-shirt Size

XS

S

M

L

XL

Child 3 Name

First Name

Last Name

Child 3 Age

3 years old

4 years old

5 years old

Kindergarten Completed

1st Grade Completed

2nd Grade Completed

3rd Grade Completed

4th Grade Completed

5th Grade Completed

Child 3 T-shirt Size

XS

S

M

L

XL

Child 4 Name

First Name

Last Name

Child 4 Age

3 years old

4 years old

5 years old

Kindergarten Completed

1st Grade Completed

2nd Grade Completed

3rd Grade Completed

4th Grade Completed

5th Grade Completed

Child 4 T-shirt Size

XS

S

M

L

XL

Child 5 Name

First Name

Last Name

Child 5 Age

3 years old

4 years old

5 years old

Kindergarten Completed

1st Grade Completed

2nd Grade Completed

3rd Grade Completed

4th Grade Completed

5th Grade Completed

Child 5 T-shirt Size

XS

S

M

L

XL

I give permission to Fellowship Wesleyan to take photos of my child during VBS (August 2nd-August 5th 9:30-11:30AM). I am aware that all photos at VBS will be taken with other students and two adults present.

I agree

I give Fellowship Wesleyan Preschool permission to place my child’s photo on the church’s website.

Yes

No