AUMC Vacation Bible School 2018 Registration
Monday, June 18 - Friday, June 22, 9 a.m. - noon
Preschool Children Age 3 through Completed 4th grade
(MUST BE AGE 3 BY SEPT. 30, 2017 AND TOILET TRAINED)

Registration fee is $20 for one child, $10 for each additional child, and $40 maximum per family* to secure a place in Church Day Camp. This fee includes craft supplies and snacks. Pay online by going to annandale-umc.org , clicking on "Online Giving", and selecting a one-time donation in the appropriate amount. Or you can drop off your payment in the church office or mail it to: AUMC, 6935 Columbia Pike, Annandale, VA 22003. Make checks payable to AUMC, with "Vacation Bible School" in the memo line.

*Scholarships available; please contact the church office (703-256-8330) for more information.
**If your child has food allergies, know that we will make every effort to accommodate you, but you may want to PROVIDE snacks for your child.

Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Birth Date *
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DD
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YYYY
Grade Completed as of June 2018 *
Church Attended
Your answer
Parent or Legal Guardian's Name(s) *
Your answer
Contact's Primary Phone *
Your answer
Contact's Alternate Phone
Your answer
Contact's Email *
Your answer
Home Address *
Your answer
City *
Your answer
State *
Your answer
ZIP code *
Your answer
Child's Primary Physician *
Your answer
Physician Phone *
Your answer
Does your child take medication on a daily basis? *
If "yes", please specify.
Your answer
Known Allergies/Special Needs
Your answer
Is/are the parent(s)/guardian(s) able to volunteer? *
Parents are asked to volunteer at least ONE day per child during the course of Vacation Bible School. Free childcare is provided for your child(ren), too young to attend VBS, only on the days that you volunteer. To register as a volunteer, visit https://goo.gl/forms/67x6bYh0r3BS1o7r2 . This link will also be available after you complete this form and on the website.
During Vacation Bible School week, photos and videos may be taken for use by AUMC in promotion of VBS. If you choose not to have your or your child(ren)'s photos or videos used, please sign an AUMC Photo Opt Out form, which may be obtained from the AUMC church office. These forms will be retained on file. A complete disclosure of AUMC's photo/video policy is available at the AUMC church office.

AUMC has my permission in an emergency, when I cannot be contacted, to call 911 Emergency services, an EMT or the hospital has my authorization to provide treatment, which a physician deems necessary for the well being of my child. By law a parent or legal guardian cannot consent in advance to any and all manner of emergency care. It is understood in most cases, other than the need for immediate emergency treatment, the attending physician may defer treatment pending the parent or guardian’s expressed permission to administer such treatment.

BY TYPING YOUR INITIALS IN THIS BOX, YOU AGREE TO THE AUMC EMERGENCY PROCEDURES DESCRIBED ABOVE. *
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