Salem United Methodist VBS 2018
VBS 2018 Registration Form
Child's Name *
Your answer
Child's Gender
Parent/Guardian Name *
Your answer
Child Age/Grade *
Age as of June 7th and grade entering in the Fall 2018
Your answer
Parent/Guardian Phone Number *
Your answer
Parent's Email *
Your answer
Home Church
Your answer
Emergency Contact *
In case parent/guardian is not available
Your answer
Emergency Contact Phone *
Your answer
Emergency Contact Relationship
Your answer
Does child have any medical issues we should be aware of? *
If Yes, please explain
Your answer
Does child have any food allergies or special dietary needs? *
If Yes, please explain:
Your answer
Photo/Media release *
Parent/Guardian does authorize publication or release of photos taken at event to media and church website/facebook
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