VBS registration form 2024

VBS Registration Form Dunlap United Methodist Church 23674 US 33 East, Elkhart

July 15-19, 2024 for information call:
Child's Name
Date of Birth

MonthDayYear
Date
Age
Grade (in 2024-2025)
Medical Information (including any food allergies)
Child's Name
Date of Birth

MonthDayYear
Date
Age
Grade (in 2024-2025)
Medical Information (including any food allergies)
0 0 o 0 0 0 o 0 0 0 o 0 0 0 o 0
Child's Name
Date of Birth

MonthDayYear
Date
Age
Grade (in 2024-2025)
Medical Information (including any food allergies)
Parents' or Guardians' Names
Email
example@example.com
Address
City/State/Zip
Telephone
Format: (000) 000-0000.
Emergency contact name and phone
Format: (000) 000-0000.
Family Doctor and phone
Format: (000) 000-0000.
Church affiliation
People who may pick up your child(ren)
Pictures of my child(ren) may be posted on social media (no names will be included).
(Parent's Signature)

Clear
(Parent's Signature) Please note: There is no fee for this program. You may register during VBS week, but it's helpful if you can register early. You may mail/bring this form to the church office. or you may register online. www.elkhartdunlapumc.org
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