VBS Registration Form 2024
Please complete this form for each child participating in Vacation Bible School at Kirkwood United Methodist Church.  (Sorry, Google Forms is formatted this way) 
For 2023-2024 Preschool-5th Graders    
$30 for one child.  $50 maximum per family.  Full scholarships available upon request.
Preschoolers (Age 4 and Potty-trained by August 1, 2024) will have a wonderful VBS like previous years, going from one fun station to another.
K-5th Graders will choose ONE Activity for Nights 1&2  AND  ONE Activity for Nights 3&4.
Everyone will have fun on Night 5 with a Shaving Cream Battle along with hot dogs, lemonade, etc.
Sign in to Google to save your progress. Learn more
Email *
First name of child: *
Birthdate of Child
(Must be potty-trained and at least age 4 before August 1, 2024)
MM
/
DD
/
YYYY
Last name of child: *
Grade entering in Fall: *
What is this child's First Choice for Nights 1&2?
K-5th Grade choose your favorite.
Preschoolers, indicate 'My Child is a Preschooler.'
*
What is this child's First Choice for Nights 3&4?
K-5th Grade choose your favorite.
Preschoolers, indicate 'My Child is a Preschooler.'
*
Does your child have any allergies or special needs we should know about? *
Required
If yes, please list allergies or other needs. *
I hereby give permission for my child to engage in all prescribed activities, except as noted. In the event that I cannot be reached in an emergency, I hereby give permission to the physician and hospital selected by Kirkwood United Methodist Church to secure any and all medical treatment, including but not limited to, the administration of anesthesia, drugs, and/or surgery for my child named herein. *
Required
Please list insurance carrier: *
Please list child's physician and phone number: *
Name of parents/guardians: *
Mobile phone number of parents/guardians: *
Name of emergency contact if parents/guardians cannot be reached: *
Mobile phone number of emergency contact if parents/guardians cannot be reached: *
I consent to allow all pictures taken of my child to be used for publicity and/or outreach materials for Kirkwood UMC.  I hereby indemnify and hold the above organization harmless against any and all claims or damages arising out of taking or use of any picture or names of my child. *
Click here to pay and complete registration.
https://onrealm.org/KirkwoodUnitedM/give/VBS
$30 for one child
$50 maximum per family
Indicate below if you are interested in a scholarship or have other questions.  
Click here to volunteer.  There are lots of different ways to help either one night or more.
https://forms.gle/gZUcYHiCoRLmFyZV7
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Kirkwood United Methodist Church. Report Abuse