Rolling River Rampage UUMC Vacation Bible School Registration
Join us for a week of adventures "on the river" as we learn about the ways we can trust God! The week is packed with music, play, and creation. Dates are June 18-22nd from 9am to Noon each day.
Participant's Name *
Your answer
Age Group (Year Completed) *
Parent/Guardian Name *
Your answer
Primary Phone Number *
Your answer
Secondary Phone Number
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Email *
Your answer
Please note any food allergies or medical concerns we should be aware of (ie: epilepsy, ADHD, recent injuries)
Your answer
May we use images of your child online or in print for the purpose of University UMC communications? *
May we provide first aid/emergency care to your child in the event of injury or illness? *
If you/child are insured, please provide your information below, including the name of your insurance provider, plan ID, and group number.
Your answer
Emergency Contact #1 - Please list name and phone. *
Your answer
Emergency Contact #2 - Please list name and phone. *
Your answer
If there is anyone who should not pick up or have access to your child, please list their name(s) below.
Your answer
What is the primary language spoken in your child's home? *
Your answer
What size tshirt do you want? *
Additional Comments
Your answer
Name of person completing this form. *
Your answer
Relationship to child or youth. *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms