ZACHARY UNITED METHODIST CHURCH
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VACATION BIBLE SCHOOL REGISTRATION
June 13-16, 2016 5:30 pm till 8:10 pm
Please complete a form for each child attending
Open to children age 5 through 5th grade
*
Indicates required field
Child's Name
*
First
Last
Child's Date of Birth (mm/dd/yy)
*
Last Grade Completed
*
Allergies/Restrictions
*
Parent/Guardian Name
*
First
Last
Parent/Guardian Email
*
Parent/Guardian Home Phone
*
Parent/Guardian Cell Phone
*
Parent/Guardian Home Address
*
Line 1
Line 2
City
State
Zip Code
Country
Emergency Contact 1
*
First
Last
Emergency Contact Phone Number
*
Emergency Contact 2
*
First
Last
Emergency Contact Phone Number
*
PARENT VOLUNTEER
By checking the box below, you are indicating your interest and availability to assist with this event.
Parent Volunteer
*
I am interested in volunteering for Vacation Bible School
PHOTO AUTHORIZATION
By checking the box below, you are authorizing Zachary United Methodist Church to use photographs of your child/children for promotional use:
Photo Authorization
*
I agree
AUTHORIZATION OF TREATMENT OF A MINOR
By checking the box below you agree that in the event of an illness or accident you authorize Zachary United Methodist Church to consent to any diagnosis, examination, treatment or hospital care for your child which is deemed advisable by and is rendered under the supervision of a physician. You hereby release Zachary United Methodist Church and its agents from responsibility in the case of an accident or illness in connection with any authorized church activities.
Authorization of Treatment of a Minor
*
I agree
Submit
Home
About Us
The Pastor’s Bio, Our Leadership, & Contact Us
Our Mission, Beliefs, and History
Church Calendar
Job Opportunities
I'm New
Church Newsletter
Weekend Update
Worship
Stewardship
Sunday Morning Worship
Schedule a Baptism
Become a Member
Connect
Prayer Ministry
Spiritual Growth Resources
Little School
Children's Ministries
Preteen Ministries
Adult Small Groups
Music Ministries
Give
Serve
I-Serve
Missions