VBS Registration

Name of Child *

Child's Age & Grade *

Parent(s) Name(s) *

Parent(s) Phone Number *

Address *

I am giving my child permission to partake in the activities involved with the Epworth United Methodist Church's Vacation Bible School. *

Yes

In case of an emergency, I will be contatced immediately but give permission to those in charge to treat or call emergency services should an accident or injury occur. *

Yes

My child cannot eat any of the following:

Any pertinent information that we need to know to help give your child the most fun experience:

I am giving Epworth Vacation Bible School permission to allow my child to be photographed and/or videotaped during VBS activities *

Yes

No

Date *

Signature *common.clear

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VBS Registration