VBS Registration – 2024

* Child's Name:

* Grade Entering:
* Birthday:
* Age:

Parent or Legal Guardian Information

* Parent's Name:

* Home Address:

* City: * State:
* Zip Code;

Mailing Address (if different from Home Address):

City:
State:
Zip Code;

If home and cell phone are same, fill in home phone:
* Home Phone:
Cell Phone:
* Email:

Emergency Contact Information:

* Emergency Contact:
* Relationship to Child:

If home and cell phone are same, fill in home phone:
* Home Phone:
Cell Phone:

* Any food or latex allergies? YesNo
Please list:

* Medical concerns: YesNo
(Explain):

Please list names of siblings attending VBS:

Name of church you attend (if any)?

List of those who may pick your child up and relationship:

* I give Mill-Green UMC permission to include my child in any video or photo taken during VBS to be lawfully shared on the church web site and church facebook." NoYes