2022 Nokesville UMC In-Person VBS
Address: 12550 Aden Road, Nokesville, VA 20181
Church Office: 703-594-2141
Email: pastorkim1021@gmail.com
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Child Name  *
Age *
Grade Completed *
Special Needs/Allergies/Medical Information/Others: *
Parent/Guardian Name *
Email Address *
Emergency Contact Number [xxx-xxx-xxxx] *
Child T-Shirt Size  *
Photo Release: "Church VBS has my permission to use my child's photo publicly in VBS materials. I understand the images (or videos) may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use."  *
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