VBS Registration Form – Child (through grade 5) | Wesley United Methodist Church

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Child's Name (first & last)

Child's Gender

Child's Age

Grade Completed

Parent's Full Name

Email Address

City, State

Primary Phone Number

Secondary Phone Number

Emergency Contact Person

Emergency Contact Phone Number

Special Needs/Allergies

Person Responsible for Signing Child in and out of VBS

Person Responsible Phone Number

This is the person who will sign the child in and will sign the child out of VBS

Person Responsible Relationship to Child

This is the person who will sign the child in and will sign the child out of VBS

T-Shirt Size

Days Attending - Time 6-7:30 pm Please check all that apply