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Vacation Bible School June 12-15
Please register each child individually!
Contact the church office if you have any questions at 219-926-1478 or email
chesterton.umc@gmail.com
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* Indicates required question
Email
*
Your email
Child's Name
*
Your answer
Child's Gender
*
Female
Male
Child's Birthdate
*
MM
/
DD
/
YYYY
Child's Age
*
Your answer
Grade child is entering in the Fall
*
Your answer
Name of School your child is entering in the Fall
Your answer
Is child a participant or volunteer?
*
Participant
Volunteer (must be going into 5th grade or older)
If volunteering, what areas would you like to help
Activity
Crafts
Games
Music/Tech
Registration / Dismissal
Snack
Story/skits
Other:
Child's Full Address (please include city & zip)
*
Your answer
Mother's Name
*
Your answer
Mother's Phone Number
*
Your answer
Mother's Address (if different from child)
Your answer
Father's Name
*
Your answer
Father's Phone Number
*
Your answer
Father's Address (if different from child)
Your answer
In case of Emergency contact (other than parent)
*
Your answer
Emergency contact (cell/home number)
*
Your answer
Who is allowed to pick your child up from VBS? (Please give names)
*
Your answer
Religious Background/Church you attend
Your answer
May we put your child's pictures on the Church's Website, YouTube and Facebook page?
Please note - the celebration video on Sunday will be used in worship services and posted to YouTube.
*
Yes
No
Please list any allergies or other conditions which may limit activity
*
Your answer
Any other special instructions or things you would like us to know about your child?
Your answer
Send me a copy of my responses.
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