Registration 2025 – Summit Church Texas

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Parent/Guardian Name *

First

Last

Phone Number *

Address *

Email *

Child's Name *

Child's Birth date *

Last Grade Completed in School *

Medical Information/Allergies *

Medical or other information we need to know. (please include any food allergies.) If none, say N/A

Emergency Contact 01 Name and Number *

Please include: First Name, Last Name, Phone Number

Emergency Contact 02 Name and Number

Please include: First Name, Last Name, Phone Number

Who may pick up your child at the end of each VBS day? *

Please include: First Name, Last Name, Phone Number

Do you attend church? If so where? *

If you are visiting our church, who are you a guest of? *

May we have permission to photograph your child? *

May we have permission to use your child's photograph for the purpose of promotion? *