VBS Registration Form 2021
June 28 - July 2nd from 6-8:30pm

Westside Community UMC looks forward to seeing your child at VBS this year! Please complete a separate registration form for each child who will be attending. Children who register by June 10th will have a prize mailed to them. Thank you!
First and Last Name of Child *
Child's Birthdate *
MM
/
DD
/
YYYY
Last School Grade Completed: *
Address *
Medical Concerns/Allergies *
Name of Parent/Caregiver *
Primary Phone Number *
Secondary Phone Number
Emergency Contact *
Emergency Phone Number *
Church Affiliation (optional)
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy