VBS 2025 Registration Smyrna First United Methodist Church

Smyrna FUMC VBS (Student) Registration Form

Student’s Name

Parent/Family/Guardian Name

Address

E-mail Address

example@example.com

Phone Numbers: Home

Type phone number with area code first

Cell

Work

Student's Date of birth

MonthDayYear

Age

Last school grade completed

Home Church (if any)

Friends of your child at this church

Special Needs/Allergies/Medical Information/Other

Special Needs/Allergies/Medical Information/Other:

Emergency Contact Name

Emergency Contact Phone

Type phone number with area code first of who to contact in case of emergency.

Emergency Contact Name

Emergency Contact Phone

Type phone number with area code first of additional person to contact in case of emergency if applicable.

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

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

Photo Release

Name of church

VBS 2025 has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.

Parent/Guardian Name

First NameLast Name

Date

MonthDayYear

- - - - - - - (for church use only) - - - - - - -

Assigned to Group

Are family members helping with VBS?

If yes, where?

Cokesbury Kids VBS Leader Resources