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2021 VBS Sign-Up Form
Student's Name
*
Student's Date of Birth
*
Student's Age
*
Last School Grade Completed
*
Pre K
Kindergarten (K)
First Grade (1st)
Second Grade (2nd)
Third Grade (3rd)
Fourth Grade (4th)
Fifth Grade (5th)
Home Church (If Any)
Parent/Guardian Name
*
Parent/Guardian Phone Number
*
Address
*
Email
*
Special Needs/Medical Information/Allergies
*
Are any family members helping with To Mars and Beyond VBS at Central?
*
Yes
No
If Yes, Who?
Names of People allowed to pick them up from VBS
*
(2) Emergency Contacts
*
Central United Methodist Church/VBS has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, presentations, and social media. I also understand that no royalty, fee or other compensations shall become payable to me by reason of such use.
*
Yes
No
By entering you full name in the box below, you agree to the Photo Release Waiver Agreement Above
*
Submit
×