VBS Registration
Chester United Methodist Church * June 19-23, 2023, from 9:00 AM - 12:10 PM
For ages Pre-K through 5th Grade (grade completed)
Please complete a separate form for each child.
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Student's Name *
Student's Gender *
Parent/Family/Guardian Name *
Mailing Address *
E-mail Address *
Phone Numbers (Any/All) Include name next to each number. *
Date of Birth *
Current Age *
Last School Grade Completed (as of June 2023) *
Special Needs/Medical Info/Other
Emergency Contacts (Include name and phone number for each) *
Name of person(s) who may pick up from VBS *
Do you give CUMC permission to include your child's picture in CUMC social media and publications? *
Type your name and today's date below.  This will serve as a digital parent/guardian signature. *
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