New World UMC VBS Registration
Saturday July 19th from 10am-4pm & Sunday July 20th from 10am-2pm
Child's Name
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Grade Level Entering
Parent/Guardian 1
First Name
Last Name
Phone
Please enter a valid phone number.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Gaurdian 2
First Name
Last Name
Phone
Please enter a valid phone number.
Email
example@example.com
Address (If different than Parent/Guardian 1)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
First Name
Last Name
Phone Number
Please enter a valid phone number.
Who will be picking up the child?
First Name
Last Name
Special Needs/Allergies/Concerns
Submit
Should be Empty: