Epworth United Methodist Church 2017 HERO Central VBS Registration Form
VBS will be held at the new site July 16 - 20 5:45 P.M. - 7:45 P.M.
Child's Last Name *
Your answer
Child's First Name *
Your answer
Date of Birth *
Your answer
Gender *
Grade completed in School *
Parents' First and Last Names *
Your answer
City, State, and Zip Code *
Your answer
Home Phone *
Your answer
Cell Phone
Your answer
Email
Your answer
Emergency Contact Person and Phone Number *
Your answer
Allergies (include foods) *
Your answer
Other Special Needs or Requirements
Your answer
Persons picking up child/relationship to child *
Your answer
Their Phone Number (s) *
Your answer
Do you give permission for photos of your child to be used in church promotional materials? *
Required
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