VBS Registration

vbs

CENTRAL UMC/FIRST PRESBYTERIAN CHURCH

VACATION BIBLE SCHOOL

June 12-16   9-11:30 a.m. Age 3 – 5th grade

To pre-register turn the completed form into Ann Lenox  at the Presbyterian Office.

 

Child: _______________________________________Grade completed ______age____

Child: _______________________________________Grade completed ______age____

Child: _______________________________________Grade completed ______age____

Child: _______________________________________Grade completed ______age____

Parent/Guardian: _________________________________________

Address: _______________________________________________

Home Phone: ________________________

Day-Time # ____________________________

Cell # _________________________

Email Address: _______________________________________

Home Church _____________________________________________

I can make a donation to help with VBS meals & expenses: Amount $____________________  (optional) (payable to CUMC)

MEDICAL & EMERGENCY INFORMATION

EMERGENCY CONTACTS (if parent can’t be reached):

Name: _____________________________________________________

Phone: ______________________________________

Name: _____________________________________________________

Phone: ______________________________________

DISMISSAL INFORMATION – Who may pick up your child at the end of each VBS day?

_________________________________________________________________________

MEDICAL INFORMATION – Medical or other information we need to know.  (please include any food allergies): _________________________________________________________________________

OTHER INFORMATION – Do you attend church or Sunday School?  If so, where?

_________________________________________________________________________

If attempts to contact parent/guardian and other contacts fail, does Central United Methodist Church Staff and/or Leadership have permission to authorize care recommended by licensed medical professionals?               YES ________ NO ________

PHOTO RELEASE

Photos will be taken during VBS. These photos may be used on bulletin boards, for publicity outside each of the churches, on each church website, or in other church publications. Please indicate your preference below.

_____ YES, permission is granted for photo use of VBS enrollee. _____ NO, photo permission is not granted.

Signature of parent/guardian ____________________________________________________ Date _______________