VBS Registration Form"*" indicates required fieldsLinkedInThis field is for validation purposes and should be left unchanged.Parent Name* First Last Address Street Address City State / Province / Region ZIP / Postal Code Email* Daytime Phone*Cell PhoneEmergency Contact*Relationship to Child*Daytime Phone (Emergency Contact)*Cell Phone (Emergency Contact)Child #1* First Last Date of Birth* Month Day YearGrade (this Fall)Register a Second Child? YesChild #2 First Last Date of Birth Month Day YearGrade (this Fall)Register a Third Child? YesChild #3 First Last Date of Birth Month Day YearGrade (this Fall)Register a Fourth Child? YesChild #4 First Last Date of Birth Month Day YearGrade (this Fall)Health HistoryDo you have any concerns you'd like to share?ALLERGIESlist all known Food, Medications and Other allergies (i.e. bee stings)Child #AllergyReactionTreatmentCommentsΔZoom Access Permission FormEmailThis field is for validation purposes and should be left unchanged.I give my permission for my child(ren) to attend church gatherings via Zoom.* Yes NoI give my permission for a clip or photo of my child(ren) in a Zoom session to be used on the Oak Grove website or Facebook page, making sure no names are visible.* Yes NoChild(ren) Name(s)*Parent/Guardian Name*Parent/Guardian Initials*Δ
