Name of Student *
Name of Student
Address *
Name of Parent *
Name of Parent
Parent Phone Number *
Parent Phone Number
Emergency Contact *
Emergency Contact
Emergency Contact Number *
Emergency Contact Number
Parent/Guardian Consent *
I give consent for my child to join the Hopeton Church Vacation Bible School and I fully understand the rules that have been set forth for my child to follow. The health information is correct, so far as I know, and I give permission to the church medical team to administer medical aid as required for illness or injury under a physician's orders (including transportation to and from the necessary facilities).