VBS - Maker Fun Factory - Registration Form
July 9th-14th at Triplett UMC - 5:30pm-8:00pm Children ages 3-5th grade - Supper served nightly.
Child's last name
Your answer
Child's first name
Your answer
Date of birth
MM
/
DD
/
YYYY
Child's age
Your answer
Last school grade completed
Your answer
Child's gender
Name of parent(s)/guardian(s)
Your answer
Street address
Your answer
City
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State
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Zip
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Parent/Guardian's home phone/cellphone number - Enter the number at which one can most likely be contacted. You may enter both.
Your answer
Email address
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Home church
Your answer
Is there a friend with which your child would liked to be placed? If so, enter the friend's first and last name here.
Your answer
Allergies or other medical conditions - Enter NA if this does not apply.
Your answer
Emergency contact name
Your answer
Emergency contact telephone number
Your answer
Emergency contact relationship to child
Your answer
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