First United Methodist Church

Student VBS Registration
June 22-26th - 6-8:30 pm

4 years through entering 6th grade
(3 year old children of FUMC members may participate. Must be 3 by July 22th.)

Instructions: Please fill out the form below in its entirety before clicking on the SUBMIT button. To travel in-between fields use the TAB key not ENTER or your registration may be submitted prematurely.
(One registration form must be completed for each child)

First Name:	Last Name:	Gender:	male female
Home Phone:
Address:
City:	State:	Zip:
Current grade:	Birth Date:	Age:
Parent/Guardian Name:	Email:	Cell Phone:

Allergies or Medical Concerns: (children with severe food allergies are welcome to bring a snack from home)

I am a guest of:		My Church Home:
Emergency Contact Name:		Emergency Contact Phone:
Is parent/guardian volunteering in VBS?	yes no
	T-shirt size (check one)
	youth XS S M L adult S M L XL

Please list names of siblings attending:		Miscellaneous information you want us to know: