VBS Student Registration Form
Green Camp UMC
Basic Information
Student Name
*
First Name
Last Name
Student's Date of Birth
*
-
Month
-
Day
Year
Age
*
Note on Younger Children
While we welcome children of all ages at our VBS, we require a parent or guardian to accompany children who are not potty trained. With questions, please email us at info@greencampumc.org.
Home Church
If none, leave blank.
Last School Grade Completed
*
Please Select
None
Preschool
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Student's Home Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Medical Conditions, Allergies, or Restrictions
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Emergency Contacts
Contact 1 Name
*
Phone
*
Format: (000) 000-0000.
Email Address
This email address will receive emails about VBS.
Contact 2 Name
Phone
Format: (000) 000-0000.
List anyone else who is allowed to pick up your child from VBS:
To ensure student safety, children will not be released with adults not named on this form. If you need to add or remove authorized guardians later on, email the church office or let the registration desk know at arrival.
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Photo Release
I hereby authorize Green Camp United Methodist Church 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, along with other mediums. I also agree that no royalty, fee, or other compensation shall become payable to me by reason of such use.
I'd like to receive occasional emails about upcoming events at GCUMC!
I'd like to receive texts from GCUMC.
Submit
Should be Empty: