St. Paul UMC Passport to Peru VBS 2018
June 24 - 28
5:30 - 8:30
Dinner is served each night.
PreK 3 - 6th grade. (Preschool spots are limited).
Please create a new registration for each child.

St. Paul UMC
4100 Grand Ave.
Ft. Smith, AR 72904
Call 479-783-5908 if you have questions.

Child's Name *
Your answer
Child's gender *
Child's age *
Your answer
Child's Date of Birth *
MM
/
DD
/
YYYY
Last school grade completed *
Your answer
Name of parent(s) *
Your answer
Home street address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Home telephone *
Your answer
Parent/caregiver's cell phone *
Your answer
Home email address *
Your answer
Home church *
Your answer
Allergies or other medical conditions
Your answer
Name and phone number of an emergency contact *
Your answer
Any special notes or requests
Your answer
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