2016 VBS: INTO THE LIGHT
***HURRY! Registration closes 30 Nov 2016 or when maximum participants reached, whichever is sooner.
" Your word is a lamp for my feet, a light on my path " - Psalm 119:105
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Name of Child (Full Name)
in capital letters, name per registry if applicable ( eg : LILY TAN LI LI)
- child must be born between 2003-2010, age 6-13 ONLY
Day (D) or Stay In (S) program?*
*Only those aged 9 and above allowed to stay in
T Shirt Size
Please measure the child's existing t-shirt under the arms (in inches). For registration AFTER early bird deadline, T-shirt sizes subject to availability
Church child attends (if any)
Please provide us with the name of the church if applicable ( eg : KLANG WESLEY). State 'None' if the Child does not currently attend any church or sunday school program
Any medical allergies / special needs
Help us understand if your Child require special meals or need to avoid certain food (eg :NUTS, DAIRY ETC). Otherwise, state "None"
PARENT'S DETAILS & EMERGENCY CONTACT INFORMATION
Name of Child's Parent/Guardian whom we can easily reach
Parent's Contact Number
provide us with a number that child's Parent / Guardian can be reached ( eg : 012-XXX XXXX)
Parent's email address
will be used to send updates on program only ( eg :
Emergency contact (if different from parent's details)
Tell us whom to get in touch with if the need arises ( eg :John / 012-444 1234)
Bank transfer to "WESLEY METHODIST CHURCH KLANG" UOB 1713155611. Please email a copy of your bank transfer receipt to
. Before you hit submit, kindly share with us the Transaction details from your Bank.
Amount Paid (MYR)
Please refer to schedule of fees
Transaction/Receipt number of Bank Transfer
Please insert your payment reference/transfer number. This will be an auto generated number from your bank
INFORMATION & FEE SCHEDULE
ACKNOWLEDGEMENT& PARENTAL CONSENT
ACKNOWLEDGEMENT : I hereby grant permission for my child to attend VBS at Wesley Methodist Church Klang. I understand that whilst every reasonable care will be taken, I will not hold the church and her staff / helpers responsible for any mishap. I allow the organizers to take the appropriate medical attention in the event of an emergency.
PARENTAL CONSENT : As this is an electronic form, No signature is required. However, by completing and submitting this form, you are deemed to have acknowledged the contents and given your consent for your Child to be enrolled.
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