Lightstreet United Methodist Church

2018 VBS Registration Form

 

Student’s Name_________________________________________________________________

 

Parent/Family/Guardian Name __________________________________________________________

 

Address________________________________________________________________________________

 

_________________________________________________________________________________________

 

E-mail Address_________________________________________________________________________

 

Phone Numbers  Home ____________________ Cell ______________________Work___________________

 

Date of birth _______________________________ Age ________________________

 

Last school grade completed ______________________________________________

 

Home Church_____________________________________________________________________________

 

Friends of your child at this church_____________________________________________________________

 

Special Needs/Allergies/Medical Information/Other:________________________________________________

 

_________________________________________________________________________________________

 

 

I, ___________________________________(Guardian signature)   GRANT         DO NOT GRANT (please

circle one) permission for Lightstreet United Methodist Church to use pictures of my child

 

___________________________(name of child) on their website for information/promotional purposes.

 

Emergency Contacts:

 

Name ________________________________________Phone __________________________________

 

Name ________________________________________Phone __________________________________

 

Dismissal Information:

Name(s) of person(s) who may pick up this child from VBS

 

_______________________________________________________________________________________

 

Other Information (church use only)

 

Rafter Group ____________________________________________________________________________________

 

Are parents/guardians/family members helping with Rolling River Rampage? ___________

 

If yes, where? _____________________________________________________________________________________

 Rolling River Rampage Leader Resources

Permission to photocopy this page for use with Rolling River Rampage is granted for local church use. Copyright © 2017 Abingdon Press. All rights reserved