Road Trip: Route 66 Edition | First Christian Church of Chandler

Parent / Guardian Information

We need this to reach you during VBS week.

Parent or guardian full name *

Phone number (call or text) *

Email address *

Street address *

Emergency contact (someone other than you) *

Emergency contact phone *

Emergency contact relationship to child(ren) *

Child 1

Required. Fill in your first child’s information below.

Full name *

Name your child goes by (optional)

Date of birth *

Grade entering Fall 2026 *

Allergies (food, medication, environmental)? (leave blank if none)

Other medical conditions or medications we should know about? (optional)

Dietary restrictions for dinner? (optional)

Which nights do you expect Child 1 to attend? *

Photo and video permission for Child 1 *

Yes, FCC Chandler may use photos or videos of this child for church-related purposes, including the church website and social media.No, please do not use photos or videos of this child.

Child 2

Registering more than one child? Fill in below. Skip if not applicable.

Full name (optional)

Name your child goes by (optional)

Date of birth (optional)

Grade entering Fall 2026 (optional)

Allergies? (optional)

Medical or dietary info? (optional)

Photo/video permission for Child 2 (optional)

Yes, FCC Chandler may use photos or videos.No, please do not use photos or videos.

Child 3

Skip if not applicable.

Full name (optional)

Name your child goes by (optional)

Date of birth (optional)

Grade entering Fall 2026 (optional)

Allergies? (optional)

Medical or dietary info? (optional)

Photo/video permission for Child 3 (optional)

Yes, FCC Chandler may use photos or videos.No, please do not use photos or videos.

Pickup Authorization

Applies to all children listed on this form.

List the full names of every adult authorized to pick up your child(ren) *

Parent / Guardian Permission

Please read the following carefully before submitting. This applies to all children listed on this form.

I give permission for my child(ren) to attend and participate in Vacation Bible School activities at First Christian Church of Chandler, including Bible lessons, music, games, crafts, skits, meals, and other supervised church activities.

I understand that ordinary risks may be involved in children’s activities, including active games, crafts, food service, and group activities. I agree to provide any important medical, allergy, or pickup information needed to help church staff and volunteers care for my child(ren).

In the event of an illness, injury, or emergency, I authorize First Christian Church of Chandler staff or volunteers to contact emergency medical services and seek appropriate medical care for my child(ren) if I cannot be reached promptly.

I have read and agree to the above. *

Signature

Type your full name as your electronic signature.

Parent or guardian signature (type your full name) *

Today’s date *

VBS Registration