Child's Name *

First Name

Last Name

Parent/Guardian Phone # *

(###)

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Child's Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact

(###)

###

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Optional Busing

If you are looking to have your child bused to GVT on the days they will attend VBS, please select which of the following pick-up times and locations you will use (your child will also be dropped off at their pick-up location when VBS ends for the day).

East End Rec Center at 5:00pm

Maplewood Community Center at 5:15pm

Permission Notice *

Goodview Trinity Church has the right to photograph/film the minors above in any manner for any lawful purpose. By selecting this checkbox, I give permission to Goodview Trinity Church to use and display any said images for promotional use of the church or activities supported by the church. Goodview Trinity Church will not be held liable for any injury to child or damage to child's property while participating in this VBS program. I also give permission to Goodview Trinity Church to seek emergency medical attention for my child in the case of an emergency, and agree to pay all expenses incurred related to that care.

I agree