Pleasant Grove Baptist Church - SC

2026 Kid's Week (VBS)

Child's First Name

Child's Last Name

Birthdate

Gender

School Grade Completed

Allergies

Primary Guardian

Mother

Father

Grandparent

Other

Guardian First Name

Guardian Last Name

Guardian Phone Number

Guardian Email

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Is the Primary Guardian the same person as the child's Emergency Contact?

Yes

No

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone Number

Church Home

May we photograph the child?

Yes

No

May we use the child's photograph for promotional purposes?

Yes

No