Fellowship Baptist Church

Star's Name: (Child)

Birthdate (including year):

School Grade just completed as of June:

Address:

City:

Zip

School:

Name of church you attend on regular basis:

Invited By:

Parent/ Guardian (first & last name):

Cell Phone

Food allergies or medical concerns:

For 6th and 7th Grade only ......

Can you swim?

I give my child permission to participate in the Junior High Vacation Bible School program. I understand that he/she may leave the grounds of Fellowship Baptist Church periodically for activities and events. I will not hold Fellowship Baptist Church or any chaperone liable for any loss or injury. In the event of an emergency please contact me at the phone number provided.

I agree