VBS RegistrationChild's InformationChild's Name(Required) First Last The child’s legal nameAge in August(Required)SELECT AN AGE456789101112Age of the child on the first day of VBS.Date of Birth(Required) MM slash DD slash YYYY School Grade in FallSELECT A GRADEPre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th GradeThe school grade the child will enter in the fall.Sex of Child(Required)SELECT CHILD'S SEXMaleFemaleThe child’s legal sex as list on their birth certificate.AllergiesGuardian InformationName of Guardian(Required) First Last Enter the name of the child’s legal guardian.Guardian Phone Number(Required)Guardian Alternative Phone NumberAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Guardian Email Address Other InformationDoes the child have a church affiliation?SELECT A CHOICEYESNOAre there any accommodations used in other settings for your child that might be helpful for us to be aware of?Do you give permission for the supervised use of sunscreen for the above named child?YESNODo you give permission for the supervised use of bug spray for the above named child?YESNO*** Advisories ***Pictures from VBS could be posted on any of Quidnessett Baptist Church’s social media sites, newsletters, websites, or other digital properties. If, for legal reasons, your child’s image cannot appear online, please contact the church office at 401-884-9111.Quidnessett Baptist Church does not administer medications except those needed in case of an emergency, such as an Epi-pen or an inhaler. (Those items must be in their original container with the prescription label indicating the child’s name).Consent(Required) Event: 2025 VBS Day Camp at Quidnessett Baptist Church, 6356 Post Road, North Kingstown, Rhode Island 02852, August 4-8, 2025. By signing below, I assume any risk of harm or injury which might occur to the participant due to his/her participation in the event or activity, I release the organization or business named above, as well as it’s staff, volunteers, and agents, from all liability, costs and damages which might arise from participation in the above named event or activity. If the participant is a minor, I agree that the minor has my consent to participate in the event. I further provide my consent for the organization or business named above to seek emergency treatment for the minor if necessary. I agree to accept financial responsibility for the costs related to any emergency treatment. I agree to the above termsΔ
