Advent UMC Summer 2019 Program Registration
Child's Last Name *
Your answer
Child's First Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Gender
Grade (Fall 2019) *
Your answer
SPECIAL NEEDS/MEDICAL (i.e. food allergies, vegetarian, autism, etc.)
Your answer
OTHER CONCERNS - Information we should know about (i.e. fears, concerns)
Your answer
PARENT/CAREGIVER INFORMATION - Parent #1 Full Name
Your answer
Parent #1 Email
Your answer
Parent #1 Work phone
Your answer
Parent #1 Cell phone
Your answer
PARENTAL INFORMATION - Parent #2 Full Name
Your answer
Parent #2 Email
Your answer
Parent #2 Work phone
Your answer
Parent #2 Cell phone
Your answer
Street Address
Your answer
City/State/Zip
Your answer
By registering, you are giving permission for your child's photograph to be used in church publications and online - on the church website and Smugmug, where pictures are displayed but identities are not revealed.
Vacation Bible Camp June 24-28 (9am-12pm)
One Day Fun Days July 9-11
Music & Drama (MAD) Camp July 29-Aug. 2
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