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Event registration
Event Timing: June 19th - 22nd, 2023
Event Address: 1800 S 13th Street, Kingfisher, OK 73750
Contact us at (405) 375-3286
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Child's Name
*
Your answer
Grade Child Will Be Entering
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Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Parent/Guardian Name
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Your answer
Parent/Guardian Phone Number
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Your answer
Parent/Guardian Email
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Your answer
Mailing Address
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Your answer
City
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Your answer
State
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Your answer
Zip Code
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Your answer
Medical Concerns or Food Allergies We Should Be Aware (Please be specific.)
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None
Other:
Kingfisher FUMC may use pictures of my child participating in VBS on their website and social media accounts.
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Yes
No
Do you have a home church?
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Yes
No
T-Shirt Size
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Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Is there any other information about your child that you feel we need to know?
Your answer
1) Emergency Contact Information - Name & Phone Number:
*
Your answer
2) Emergency Contact Information - Name & Phone Number:
Your answer
Do we have consent to treat your child's minor injuries if necessary?
*
Yes
No
Emergency Information: In extreme medical emergency when neither parent/guardian can be immediately contacted, the pastor or her designee will secure the services of the local paramedics or ambulance services.
Parent/Guardian signature - Typing your name is the equivalent of an electronic signature.
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