VBS Registration Form
Registration form for VBS at Bethel United Methodist Church (481 Delsea Drive, Sewell, NJ 08080)

DATES: Monday 6/20 through Friday 6/24
TIME: 6:00 PM - 8:30 PM
AGES: 4 through 11 years old


For more information call: 856-589-1745

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Email *
Child's Name: *
Child's Age (4 through 11 yrs old): *
Last School Grade Completed: *
Name of Parent(s) or Guardian: *
Parent/Guardian email address: *
Home Street Address: *
City: *
State: *
Zip code: *
Home Phone #: *
Cell Phone #:
Child's Allergies (specify "None" if child does not have any allergies): *
Child's Medications (specify "None" if child does not take any medications): *
In case of emergency, contact (name): *
Emergency contact phone number: *
Insurance Company: *
Insurance ID # *
Insurance Group # *
List any medical conditions that would prevent your child from participating in active sports, climbing stair, etc.:
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