Vacation Bible School (Counselor and Staff Registration)
Date: July 1-5
Time: 9 am - 12 noon
Location: Los Banos United Methodist Church 1031 Iowa Ave. Los Banos, CA
Name *
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Email *
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What would you like the kids to call you? *
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If counselor under age 21: Age in June? And Birthdate: *
Your answer
Address: *
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Phone Number: *
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Primary Emergency Contact: Include Name, Phone and Relationship to you. *
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IF UNDER 21 Secondary Emergency Contact: Name, Phone and Relationship to you.
Your answer
Please list any health concerns or allergies:
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In case of emergency, I understand that the VBS directors will make every effort to contact my emergency contact person(s) prior to any treatment. I also give permission for the directors of VBS to take necessary action for my health in the event that I become incapable of giving informed consent and my emergency contact person(s) cannot be reached. (If you are under 18, please have a parent/guardian complete this question) *
Required
Have you been a VBS Counselor/helper in the past? If so how many years?
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Counselor/Staff t-shirts will be provided. Please indicate what size you would like: *
Required
Have you accepted Jesus Christ as your personal Lord and Savior? *
What things do you do in your life because you are a Christian? *
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What Church do you attend and do you attend often? *
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Have you ever shared your faith with others? *
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What area of VBS would you most like to participate in? *
Required
Any other area you'd like to help please list here:
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