VBS Registration – Harmony United Methodist Church

General Information
Vacation Bible School is open to 4 year olds through rising 5th graders.
Student's Name*
First Last
T-Shirt Size*
Parent / Family / Guardian Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email Address*
Home Phone*
Cell Phone*
Work Phone
Preferred Number*
- Home
- Cell
- Work
Child Information
Date of Birth*
Date Format: MM slash DD slash YYYY
Age*
Last school grade completed*
Friends of your child enrolled in VBS
We will make sure your child is with at least one of their friends. Use the + icon to add additional names.
Special Needs / Allergies / Medical Information / Other
Emergency Contacts
Name*
First Last
Phone*
Name*
First Last
Phone*
Dismissal Information
Name(s) of person(s) who may pick up this child from VBS*
Use the + icon to add additional names.
Comments
This field is for validation purposes and should be left unchanged.

General Information