Rocky Railway: Jesus' Power Pulls Us Through
It's that time of year again! This year's Vacation Bible School (VBS) at Crozet United Methodist Church (CUMC) will take place June 26th-June 30th 2023. Children who are at least 3.5 years old (who are fully potty trained, i.e. independent in the restroom with minimal accidents) through rising 5th graders are eligible to attend. There is no cost associated with attending VBS at CUMC. Please complete one registration form per child. 

Questions may be directed to our Director of Children's Ministries, Victoria Raymond, by emailing her at kingswood@crozetunitedmethodist.org or calling/texting her during normal business hours at 434-823-1258. We look forward to seeing you in June!
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Email *
Child's first and last name: *
Child's preferred name or nickname: *
Child's birthdate: *
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My child will be _________ years old on June 26th, 2023. *
Do you have more than one child attending VBS at CUMC this year? If so, please list siblings names and ages below. (Note: You will still need to complete one registration form for each child--this field is to ensure we know which children are siblings):
Child's gender:
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School child attends:
Child's grade level for the 2023-2024 school year: *
Home church (if applicable):
Parent/Guardian #1 Name *
Parent/Guardian #1 Phone Number *
Parent/Guardian #1 Email Address *
Parent/Guardian #2 Name *
Parent/Guardian #2 Phone number *
Parent/Guardian #2 Email Address *
Emergency Contact #1 Name *
Emergency Contact #1 Phone Number *
Emergency Contact #2 Name *
Emergency Contact #2 Phone Number *
Other persons authorized to pickup the child (other than parents/guardians and emergency contacts):
Allergies: *
Medical issues or special needs:
Permission to Attend: I give permission for my child (named above) to attend the Vacation Bible School (VBS) listed above. I understand that the information I give for this registration will only be used by the hosting church for purposes related to VBS.
 *
Medical Release: I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me.
 *
Photo Release: I hereby grant the above named church permission to copyright and use photographs/videos taken at VBS of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.   
 *
How did you hear about VBS at CUMC?
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I'm willing to volunteer on the following days: *
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Is there anything else you would like us to know about you and your family? Custody arrangements, developmental delays, etc.?
A copy of your responses will be emailed to the address you provided.
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