Beulah UMC VBS 2022

Beulah UMC VBS 2022
Application Instructions:
- Please fill out this application fully and to the best of your ability.
- If you need to register multiple children, please register each child individually. (Individual registrations required)
- All student's registrations must be signed by their parent(s) or guardian(s).
- Late registrations will be reviewed but not guaranteed acceptance.
If you have any questions, please contact:

Pastor Daniel Chun (Beulah's Next-Gen Pastor) @ 6469152992 or daniel@beulahumc.org
Registering for? *

Student Leader/Volunteer

Name of Student *

First Name Last Name
Their Age (As of August 2022)
Their Grade (2021-2022 School Year)
T-Shirt Size (Youth Size)

XS S M L XL

Name of Parent/Guardian *

First Name Last Name
Parent/Guardian's Email
example@example.com
Parent/Guardian's Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Your Name *

First Name Last Name
Email
nextgen@beulahumc.org
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
T-Shirt Size (Adult Size)

S M L XL XXL

Medical Information
Does your child (or yourself) have any food allergies? Please list all below.
Does your child (or yourself) have any medical concerns and/or medications that the leaders of Beulah UMC need to be aware of? Please list all below.

Photo Release Form
Do you give Beulah United Methodist Church permission to use my child's photograph publicly in VBS materials? I understand the images may be used in print publications, online publications, websites, and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use.

YES NO

Student's Name
Print Name (Your/Parent's)
Your/Parent's Signature

Clear
Should be Empty: