Aldersgate United Methodist VBS 2018
Online Registration Form
June 25th-29th // 9am-12pm
Student's Name
Your answer
Parent/Family/Guardian Name
Your answer
Address
Your answer
Email Address
Your answer
Phone Numbers (Home, Cell, Work)
Your answer
Child's Date of Birth
MM
/
DD
/
YYYY
Child's Age
Your answer
Last School Grade Completed
Your answer
Home Church
Your answer
Friends of Your Child at This Church
Your answer
Special Needs/ Allergies / Medical Information / Other:
Your answer
Emergency Contact #1 (Name and Phone Number)
Your answer
Emergency Contact #2 (Name and Phone Number)
Your answer
Dismissal Information: (Name(s) of Person(s) Who May Pick Up This Child From VBS)
Your answer
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