VBS Registration 2023

VBS 2023: July 31st-August 4th

Time: 9am-11:30am Mon- Thurs

9am-12pm Friday (end of week celebration starts at 11:30, parents and families welcome!)

Ages 3 years old and potty trained through completed 6th grade.

REGISTRATION DEADLINE July 24th, 2023

Questions? Email childrensministry@washparkumc.org

Children Enrolled in WPUMC Preschool the week of VBS will be picked up and taken to VBS (if in Before Care) and returned to preschool after VBS.

Child #1 First and Last Name

Date of Birth

Grade just completed

Allergies or other important medical information

Food Restrictions/Aversions

Gluten Free Vegan Vegetarian Lactose Free Nut Free None

Parent/Guardian First and Last Name

This address will receive a confirmation email

Address

Phone

Child's Doctor (name and phone number)

Child # 2 First and Last Name

Date of Birth

Grade just completed

Allergies or other important medical information

Food Restrictions/Aversions Gluten Free Vegan Vegetarian Lactose Free Nut Free None

Child # 3 First and Last Name

Date of Birth

Grade just completed

Allergies or other important medical information

Food Restrictions/Aversions Gluten Free Vegan Vegetarian Lactose Free Nut Free

Child #4 First and Last Name

Date of Birth

Grade just completed

Allergies or other important medical information

Food Restrictions/Aversions Gluten Free Vegan Vegetarian Lactose Free Nut Free

I _______ give my permission for my child(ren)'s photo/video clups to be used for WPUMC promotion, celebration, advertising, etc.

DO DO NOT

I would like to help with VBS

Yes No Maybe, if I am really needed

I hearby give permission for WPUMC to call 911 for medical care for above name child(ren) should an emergency occur. I understand that a conscientious effort will be made to locate the parent named above before any action is taken as circumstances of the emergency allow. It is further understood that ll expenses associated with emergency action taken are the responsibility of the child(ren)'s parents with our without parental communication at the time of emergency. I will not hold WPUMC responsible for any injury incurred while participating in activities or performing volunteer work for either above named child(ren) or parents.

I understand

Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

VBS Registration 2023

Description

Please Fix the Following