VBS Register 2022

Child's Full Name (First, Middle, Last)

Gender

Male
Female
Prefer Not To Say

Child's Age

Fall 2022 Grade Level

Please note, we are only able to accept Pre-K - graduated 5th grade at this time.

Does your child have any food allergies?*

Yes
No

Does your child need any special accommodations(dietary, physical restrictions...etc)?*

Parent/Guardian's First Name*

Parent/Guardian's Last Name*

Address*

Phone*

Email*

Who may pick this child up from SJUMC other than the above mentioned parent/guardian?

Emergency Contact Name & Phone Number*

Child's t-shirt size*

Small
Medium
Large
X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large

Social Media Permission*

I hereby grant permission, unless otherwise stated, to St. John's United Methodist Church to use photographs and/or videos of me and/or my child taken during VBS in publications, news releases, online, and in other communications related to the mission of St. John's United Methodist Church.

I AGREE
I DO NOT AGREE

Name

This field is for validation purposes and should be left unchanged.

Vacation Bible School

at St. John's

VBS Registration