VBS Registration Form
Galactic Starveyors - June 26-29, 2017 - UMC of Swartz Creek, 7400 Miller Road, SC, MI - 6:00-8:00 PM (Dinner at 5:30)
Child's Name *
Your answer
Parent/Guardian Name *
Your answer
Address *
Your answer
Mailing Address (If Different)
Your answer
Phone Numbers *
Your answer
Email Address
Your answer
Age Information *
Your answer
Last Grade Completed
Your answer
Medical Information (including allergies) *
Your answer
Emergency Contacts (Name and Numbers) *
Your answer
Pick Up Info (who may pick child up) *
Your answer
Church your child attends
Your answer
Permission to Photograph Child
# of Family Member Attending Dinners
Your answer
Submit
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