REGISTRATION & CONSENT FORM (sign up online & submit this at Joo Chiat Gospel Hall VBS 2014)

EUNOS MRT

Child’s Particulars Full Name : _______________________________________ Date of Birth : _____________________________________ Gender (pls. circle) : Male / Female Address : ____________________________________________________________________________________ Parents’ Tel. Nos : ________________________________ (hse) ___________________________________ (hp) School Level (pls. circle) : Nursery / K1 / K2 / P1 / P2 / P3 / P4 / P5 / P6 School Name : ________________________________________________________________________________ Relevant Medical Condition (eg. Asthma, etc) : _____________________________________________________ Allergy (if any) : _______________________________________________________________________________ Dietary restriction (if any) : ______________________________________________________________________ How did you know about our VBS 2014 :

Flyer / Website / Schoolmates / Family / Friends / Joo Chiat Gospel Hall

Contact Person (in case of emergency) Full Name :

_________________________________________________________________________________

Relationship : _________________________________________________________________________________ Tel. Nos : ___________________________________ (hse) _________________________________________(hp) Email : _______________________________________________________________________________________

Consent Permission I, __________________________________________ (Name), *father/mother/guardian, allow my *child/ward _________________________________________ (Name) to participate in the Vacation Bible School (VBS) 2014 (including the VBS outing) to be held from 24th till 26th November 2014.

Signature : ____________________________

(* Please circle where applicable)

Date : ______________________

JOO CHIAT GOSPEL HALL VBS 2014 REGISTRATION ...

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