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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