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2023 VBS Registration
July 5 - 6 - 7, 6:00pm - 8:30pm
St. John's UCC Penntown
8917 E County Road 1300 N, Sunman, IN
812-623-3410
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Children's Names, first and last; (you may answer all on one form)
Your answer
Child's Birth date
*
Your answer
Last grade completed in school
*
Your answer
Parent/Guardian Name
*
Your answer
Address
*
Your answer
Mailing Address (if different)
Your answer
Phone #1 (is this mom/dad/g'ma/g'pa?)
*
Your answer
Phone #2
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Email
*
Your answer
Let us know what nights your child can attend (if possible)
Wed July 5
Thu July 6
Fri July 7
Check if Yes!
Wed July 5
Thu July 6
Fri July 7
Check if Yes!
Medical Information (Please include allergies (especially food, latex or bee stings) or other information we need to know)
*
Your answer
Emergency Contacts (other than listed above - Names & phone #)
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Your answer
Dismissal Information (who may pick up your child at the end of each VBS day? Name & phone #)
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Your answer
Does your child attend Sunday School? If so, where?
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Your answer
If your child is visiting our church, who is he a guest of?
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Your answer
May we have permission to photograph your child?
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Yes
No
May we use your child's photograph for the purpose of promotion on Facebook and the church's website,
www.stjohnsuccpenntown.org
?
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Yes
No
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