Washington Farm UMC Vacation Bible School 2021

Family Information

Parent or Guardian Name

Parent or Guardian Phone

Parent or Guardian Email

This address will receive a confirmation email

Child(ren)'s Address

Washington Farm UMC has my permission to use photos of my child(ren) WITHOUT their name(s) for fellowship, communication, or publicity.

Yes No

Emergency Information

Emergency Contact

Emergency Contact Phone

Insurance Company

Insurance Policy ID #

In order for my child to receive necessary medical treatment from medical staff and/or physicians in a medical clinic or hospital in case of illness or injury, I hereby consent to and authorize the staff or volunteers of WFUMC to obtain and consent to medical treatment for such illness or injury

I agree

Pick-up (in addition to parents or guardians)

Name of Person Approved to pickup my child(ren)

Phone Number

Name of Person Approved to pickup my child(ren)

Phone Number

Child or Children

Child # 1

First Name

Last Name

Birthday

Grade in School this Fall

Any additional information the class leader should know about your child, including allergies or special needs..

Child # 2

First Name

Last Name

Birthday

Grade in School this Fall

Any additional information the class leader should know about your child, including allergies or special needs.

Child # 3

First Name

Last Name

Birthday

Grade in School this Fall

Any additional information the class leader should know about your child, including allergies or special needs.

Child # 4

First Name

Last Name

Birthday

Grade in School Next Year

Any additional information the class leader should know about your child, including allergies or special needs.

Child #5

First Name

Last Name

Birthday

Grade in School Next Year

Any additional information the class leader should know about your child, including allergies or special needs.

Description

July 12-16 9-11:30

Welcome to Washington Farm UMC Zoom Vacation Bible School. We can only accept 27 children for this year's in-person VBS. Fill out this form and click submit. You will receive an automated message confirming receipt of your registration and a later email with information on your child's class for this summer's adventure.

Washington Farm UMC Vacation Bible School 2021

Description

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