VBS Registrations St Anthony Park
Centennial United Methodist Church
St. Anthony Park Campus
2200 W Hillside Ave.
St. Paul, MN • 651-633-7644

July 11–13
6:00 pm–8:00 pm
For children age 3 (as of June 1) thru Grade 5 (completed)
Please register by July 5

Registration fee is $10 per child with $20 family maximum
Scholarships Available

Parent(s) Name *
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Address *
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Phone *
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Emergency phone while child is at VBS *
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Email *
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Child 1 Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Grade level (Fall 2017) *
Your answer
Special Needs (learning, behavior, allergies, etc.)
Your answer
Child 2 Name
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Birthdate
MM
/
DD
/
YYYY
Grade level (Fall 2017)
Your answer
Special Needs (learning, behavior, allergies, etc.)
Your answer
Child 3 Name
Your answer
Birthdate
MM
/
DD
/
YYYY
Grade level (Fall 2017)
Your answer
Special Needs (learning, behavior, allergies, etc.)
Your answer
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