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St Paul UMC - Vacation Bible School Registration Form
Children ages 2 y.o. through 6th grade welcome!
Email address *
The journey begins June 18-21, 2018
Student Name: *
Your answer
Student DOB: *
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DD
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YYYY
Student Age: *
Your answer
What grade level did your child last complete? *
Parent / Guardian Name: *
Your answer
Home Address: *
Your answer
Phone # - Home: *
Your answer
Phone # - Cell: *
Your answer
Phone # - Work *
Your answer
Emergency Contact #1: (Name / Relationship to child / Phone #) *
Your answer
Emergency Contact #2: (Name / Relationship to child / Phone #) *
Your answer
Church Home: *
Your answer
Medical Information: (allergies or other medical information that will help us best take care of your child) *
Your answer
Dismissal Information: Names of the person(s) who will be picking your child up from VBS *
Your answer
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