Vacation Bible School Registration Form
St Paul United Methodist Church
Email address *
Who can attend?
Children 3 years old to rising 6th grade are welcome!
Our journey begins June 10 - 13, 2019!!
Student Name: *
Your answer
Student DOB: *
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DD
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YYYY
Student Age: *
Your answer
What grade level did your child last complete? *
Parent / Guardian Name: *
Your answer
Home Address: *
Your answer
Phone # - Home: *
Your answer
Phone # - Cell: *
Your answer
Phone # - Work *
Your answer
Emergency Contact #1- Name / Relationship to child *
Your answer
Emergency Contact #1 - Phone # *
Your answer
Emergency Contact #2 - Name / Relationship to child *
Your answer
Emergency Contact #2 - Phone # *
Your answer
Church Home: *
Your answer
Medical Information: (allergies or other medical information that will help us best take care of your child) *
Your answer
Dismissal Information: Name of the person(s) who will be picking your child up from VBS *
Your answer
Will the person picking your child up be volunteering at VBS? *
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