VBS Registration 2025 "Road Trip: On the Road with God"

VBS 2025 "Road Trip: On the Road with God"

Mon thru Fri, 07/21/2025-07/25/2025. FREE Meal 5:30pm, Activities 6:00pm to 8:00pm
Crossroads United Methodist Church
515 E. Markey Parkway
Belton, MO 64012

Age 4 and up

More info here:
www.crossroads-umc.net
Child's Name*

First NameLast Name
School Grade Level Child Will Enter in the Fall*
Select grade level in the dropdown box
Child's Age*
Child's Gender*

FemaleMale
Child's Special Needs or Allergies
Parent/Guardian's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Main Phone Number*

Area CodePhone Number
Additional Phone Number

Area CodePhone Number
Email*
example@example.com
EMERGENCY CONTACT NAME*

First NameLast Name
EMERGENCY CONTACT PHONE #*

Area CodePhone Number
Person Responsible for Pickup After VBS*

First NameLast Name
Phone Number of Pickup Person*

Area CodePhone Number
Their relationship to the child*
Do you agree to allow photos of your child to be used in church presentation or church promotional materials? (NO child's name is disclosed, picture only)*

YesNo
Would you like more information about CrossRoads UMC via email?*

YesNo
In the event of a medical emergency, you will be contacted immediately and your child will be transported to the nearest hospital for emergency care until you are able to get there. Do you consent to this Medical Authorization?*

YesNo
Should be Empty:

VBS 2025 "Road Trip: On the Road with God"