Child's Name:

Full Name

Child's Residential Address

Street Address
Address (cont.)
City
State
Zip Code

Parent/Guardian Telephone Contact Information (Where Parent/Guardian may be reached)

Home Phone & Work Phone

Age of Child

Child's Age at Last Birthday

Child's Date of Birth

Date of Birth (month/day/year):

School Grade Completed

Last School Grade Completed

Parent/Guardian's Name

Parent/Guardian's Name

Would Parent/Guardian be willing to help with Bible School?

If so, name and area in which you would help

Church Where Child Currently attends Sunday School

Where child attends Sunday School

Any Medical Information We Need to Know (Allergies to Latex, Nuts, etc. or Asthma or Diabetes etc. )

Any Medical Information We Need to Know

Emergency Contact Information if parent listed above is unavailable
(Other parent, Grandparents, Babysitter, Neighbor, etc.)

Other Emergency Contact and Phone

Who is authorized to pick your child up from VBS?

          Authorized to pick up

Comments or Remarks

Remarks

Email Confirmation Address (We will confirm your child's registration by email!)

Email

Do you need transportation for your child?

                      Yes or No 

May FUMC use your child's photo in worship, flyers, or on the website?

                      Yes or No 

Would you like to purchase a  CD/ CD ROM with the music of VBS and games for $3.50?

                       Yes or No