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"Roar" VBS Registration

Monday, August 12, 2019 9:00 AM 09:00
Friday, August 16, 2019 12:00 PM 12:00

Google Calendar ICS

Parent/Guardian:

First Name

Last Name

Parent/Guardian Address

List your street address.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent/Guardian Phone

(###)

###

####

Parent/Guardian Email

Parent/Guardian Permission

Emergency Contact

First Name

Last Name

Relationship to Child

Phone 1

Emergency Contact Phone:

(###)

###

####

Emergency Medical Authorization

In case of emergency, if I cannot be reached by phone, I hereby give consent to Saint Andrew's United Methodist church staff and/or chaperones to seek medical treatment for my child.

Photo Authorization

I authorize Saint Andrew's United Methodist Church permission to use my child's likeness (photo/video) for the church website and/or social media. Saint Andrew's UMC will not provide names or any other identifying information related to my child.

Child's Name (1)

First Name

Last Name

Child's birth date

YYYY

Grade completed in spring of 2019 (Indicated "Preschool" if age 3 through pre-K.)

Allergies (Child 1)

List any allergies your child may have.

Child's Name (2)

First Name

Last Name

Child's birth date

YYYY

Grade completed in spring of 2019 (Indicated "Preschool" if age 3 through pre-K.)

Allergies (Child 2)

List any allergies your child may have.

Child's Name (3)

First Name

Last Name

Child's birth date

YYYY

Grade completed in spring of 2019 (Indicated "Preschool" if age 3 through pre-K.)

Allergies (Child 3)

List any allergies your child may have.

Child's Name (4)

First Name

Last Name

Child's birth date

YYYY

Grade completed in spring of 2019 (Indicated "Preschool" if age 3 through pre-K.)

Allergies (Child 4)

List any allergies your child may have.

Note: Each child you plan to bring must be registered by completing this form. REGISTRATION DEADLINE: 9 A.M. AUGUST 12.

All children MUST be signed in and checked out by the parents/guardians listed on the registration form. Saint Andrew’s United Methodist Church reserves the right to check parent’s/guardian’s driver’s licenses for identification.