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2019 VBS in the Park Registration
Please complete the following registration to join New Richmond United Methodist Church at Mary Park,
July 29 - Aug 1, 9-1130am.

ALL Children are invited to join us! If your child is not yet potty-trained, please plan to have an adult stay with them throughout the morning.


Questions? Call 715-246-2464 or email heatherb@boormancounseling.com

Child's Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Age (as of Aug 1, 2019) *
Your answer
2019-20 Grade *
Your answer
Parent / Guardian Name *
Your answer
Address *
Your answer
Email *
Your answer
Phone *
Your answer
Home Church *
Your answer
Emergency Contact (name & phone) *
Your answer
Dismissal Information: Name(s) of person(s) who may pick up this child from VBS *
Your answer
Allergies / Medical Information / Other information that will help us meet your child's needs *
Your answer
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