Shueyville UMC Children's Ministries - 380 Kids
2019- VBS RegistrationAges 3 (potty trained) - 4th Grade
Email address *
Parent/Guardian #1 Name (First & Last) *
Your answer
Cell Phone Number *
Your answer
Parent/Guardian #2 Name (First & Last)
Your answer
Cell Phone Number
Your answer
Email Address Parent #2
Your answer
Student Name (First & Last) *
Your answer
Date of Birth *
Your answer
Grade Just Completed *
Does this child have any allergies/health concerns? *
Explain allergies/health concerns.
Your answer
I am interested in helping with VBS *
If you want to volunteer, what would you like to do?
Your answer
I will allow photos/video clips of my children in the SUMC building. *
I will allow photos/video clips of my children on the church website. *
I will allow photos/video clips of my children on Facebook and Instagram. *
In case of an emergency, I understand every effort will be made to contact me. If I cannot be reached, I hereby give a representative of Shueyville United Methodist Church of Shueyville, IA, permission to act on my behalf in seeking emergency treatment for my child. I give permission to those administering emergency treatment to do so using those measures deemed necessary to support the life of my child. I absolve the representative from Shueyville United Methodist Church of Shueyville, IA, from all liability in acting on my behalf in this regard. *
Is there anything you would like for us to know about your child?
Your answer
To register another child, please complete this process again.
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