To Mars and Beyond VBS Registration/Formulario de registro de VBS
First UMC Grand Prairie (Ignite and CCM)
121 N. Center St.
Grand Prairie, TX 75051

VBS for 4 year old through students who just finished 5th grade.

Sunday, July 14th - 12:30-3:30pm
Monday - Thursdays, July 15-18th 9:00-12:00.

For more information or questions, please contact Niki Burdett at NicoleChristine84@gmail.com

Please fill out 1 form per child attending VBS.

Student's Name/Nombre del estudiante *
Your answer
Parent/Family/Guardian Name - Nombre padre / madre / familia / tutor *
Your answer
Address/Dirección *
Your answer
Email Address/Dirección elelctrónica *
Your answer
Phone Number/Teléfonos *
Your answer
Date of Birth/Fecha de nacimiento *
MM
/
DD
/
YYYY
Age/Edad *
Last School Grade Completed/Último nivel escolar alcanzado *
Home Church (if any)/Iglesia (si asiste a alguna)
Your answer
Friends of your child at this church/Amigos de su hijo o hija en esta iglesia
Your answer
Special Needs/Allergies/Medical Information/Other - Necesidades especiales / alergias / información médica / otros datos
Your answer
Emergency Contact 1 Name/Contactos en caso de emergencia nombre 1 *
Your answer
Emergency Contact 1 Phone Number/Contactos en caso de emergencia Teléfono 1 *
Your answer
Emergency Contact 2 Name/Contactos en caso de emergencia nombre 2
Your answer
Emergency Contact 2 Phone Number/Contactos en caso de emergencia Teléfono 2
Your answer
Shirt Size *
I would like to volunteer at VBS! *
Required
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