2023 VBS Allergy Form

Kid's Name

Parent/Guardian Name

This address will receive a confirmation email

Describe your child's allergy

Describe what kind of reaction your child gets from the allergy

What protocol should we follow in the event of an allergic reaction

Emergency Contact Name #1

Relationship to Child

Emergency Contact Phone #1

Emergency Contact Name #2

Relationship to Child

Emergency Contact Phone #2

Signature: By typing in your name, you agree to the above statement of permission

Description

Please completely fill out this form and submit, in order that we may better serve you and your child in the event of an emergency.

By registering, you assume any and all risks associated with COVID-19 and release NOEFC and Faith Force Kids from any and all liability.

2023 VBS Allergy Form

Description

Please Fix the Following