Posted on Thu, Jun 11, 2015
Printable version available
VBS REGISTRATION: Mount Everest
Rossford United Methodist Church
July 20-23, 2015 5:15-8:30 pm.
Child's name________________________________________________________________________
Parent/Guardian Name: _______________________________________________________________
Address: ___________________________________________________________________________
____________________________________________________________________________________
Email Address: ______________________________________________________________________
Phone Number (Home)___________ (Cell) _____________ (Work) _____________
Age Information
Date of Birth: ________________ Age: ______________
Last school grade completed: _______________________
Home Church: ________________________________________________________________________
Allergies/Medical Information/Other:
_____________________________________________________________________________________
_____________________________________________________________________________________
Emergency contacts:
Name: ________________________________________ Phone: ______________________
Name: ________________________________________ Phone: ______________________
Dismissal information: (Names of persons who may pick up this child from VBS
________________________________________________________________________________________
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