Vacation Bible School Registration
Event Timing: July 11th-14th, 2022
Event Address: 2000 S. Locust Street, Las Cruces NM  88001
Contact us at (575) 522-8220 or office@uumc-lc.org
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Email *
Name of Child *
Parent or Guardian Email Address *
Date of Birth *
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DD
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Last Grade Completed *
Name(s) of Parent(s) or Guardian(s) *
Address *
Address *
Best Phone Number to reach parent or guardian *
Emergency Contact (if parent can not be reached). Please list name and phone number *
List all people authorized to pick up your child from VBS *
Your Home Church
List any allergies or medical conditions
In case of Emergency, I give my permission to the sponsoring adults to have emergency medical care given to my child. I also release University UMC and all persons participating in church sponsored activities from any and all liability.  *
I, the undersigned parent/guardian of the child listed above give University United Methodist Church the absolute right and permission to use my child’s photograph in its promotion materials and publicity efforts. I understand that the photographs may be used in publications both print and digital, or other forms of promotion including social media. *
Signature and Date of Parent or Guardian (please type your name and date if completing online) *
A copy of your responses will be emailed to the address you provided.
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