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