2020 VBS Registration Form
We will be sending daily info during VBS in addition to links on our website. Please make sure that you are using your current e-mail address. This will be the main way we communicate.
Email address *
Family Last Name(s) *
Your answer
Phone Number *
Your answer
Address/City/Zip *
Your answer
Parent/ Guardians Name(s) *
Your answer
Emergency Contact Name *
other than parent/ guardian
Your answer
Emergency Contact Phone *
Your answer
First Child Name *
Your answer
Birthday *
MM
/
DD
/
YYYY
Grade in fall *
Your answer
Second Child Name
Your answer
Birthday
MM
/
DD
/
YYYY
Grade in fall
Your answer
Third Child Name
Your answer
Birthday
MM
/
DD
/
YYYY
Grade in fall
Your answer
Fourth Child Name
Your answer
Birthday
MM
/
DD
/
YYYY
Grade in fall
Your answer
Fifth Child Name
Your answer
Birthday
MM
/
DD
/
YYYY
Grade in fall
Your answer
Please let us know *
Required
Please list any medical concerns, allergies, special needs, or other important information *
specify which child
Your answer
By typing my name below, I understand that my children will need to be supervised by an adult at home and when engaging in VBS activities on church grounds or in public. Due to social distancing measures, PUMC will provide the activities but is unable to provide supervision. I also grant permission that photos and videos of my child (unidentified) may be included in church publications and website. *
Your answer
A copy of your responses will be emailed to the address you provided.
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