VBS Registration
July 9-12, 2017
9:00-12:00 Noon
Entering 4K - 5th grade
Child's Name: *
Your answer
Sex: *
Your answer
Grade Entering: *
Your answer
Parent's Name: *
Your answer
Address: *
Your answer
Email Address: *
Your answer
Phone: *
Your answer
Birth Date: *
MM
/
DD
/
YYYY
Allergies:
Your answer
Church you attend:
Your answer
Emergency name and number: *
Your answer
Name of a special friend your child would like to be with:
Your answer
Pictures from VBS may be placed on our website at www.helenaumc.org or used in our brochures. No children will be named in the picture. *
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