2018 VBS Registrations
Vacation Bible School 2018
Centennial United Methodist Church
1524 W. County Road C2
Roseville, MN 55113
651-633-7644

June 11–15
9:00 am–12:00 noon
For children age 3 (as of June 1) thru Grade 5 (completed)
Please register by June 2

Registration fee is $25 per child with $40 family maximum

Parent(s) Name *
Your answer
Address *
Your answer
Phone *
Your answer
Emergency phone while child is at VBS *
Your answer
Email *
Your answer
Child 1 Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Grade level (Fall 2018) *
Your answer
Special Needs (learning, behavior, allergies, etc.)
Your answer
Child 2 Name
Your answer
Birthdate
MM
/
DD
/
YYYY
Grade level (Fall 2018)
Your answer
Special Needs (learning, behavior, allergies, etc.)
Your answer
Child 3 Name
Your answer
Birthdate
MM
/
DD
/
YYYY
Grade level (Fall 2018)
Your answer
Special Needs (learning, behavior, allergies, etc.)
Your answer
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