LRUMC Vacation Bible School Registration

VBS Registration Form

These forms are required for your children to attend VBS
Student's Information
Member ID
Camper Name*
Nickname
Date of Birth*

MonthDayYear
Age
NOTE - Children need to have completed Pre-K before they are eligible to participate in VBS day camp.
Entering Grade in 2025/26*

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of the center/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18.
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Emergency Contact #1
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Format: (000) 000-0000.
Secondary Phone Number*
Format: (000) 000-0000.
Relationship to Child*

VBS Registration Form