VBS 2022 – West Newton UMC

June 5-8, 2022

2022 VBS Registration Form

Student's Name *

First

Last

Parent/Family/Guardian Name *

First

Last

Address *

Home Phone

Home phone, including area code

Work Phone

Work phone, including area code

Cell Phone

Cell phone, including area code

Email *

Dismissal Info *

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

Student's Date of Birth *

Last School Grade Completed *

Home Church

How did you hear about us? (optional)

Special Needs/Allergies/Medical Information/Other: *

Required; if none, please enter "none"

Emergency Contact *

Name and phone number of emergency contact

Shirt Size (Register by May 22 to guarantee size) *

Permission to take child's photo? *

Photos will only be used on the church website, Facebook page, and possibly Youtube as part of a montage during the worship service after the event.

Phone