2023 PUMC VBS Registration

“ Bible Boot Camp” VBS
July 31st – August 4th 2023
8:45 AM until 12:15 PM
For children 4 – rising 6th graders

This week your children will discover Bible stories, create cool crafts, play fun games, sing lively songs, and enjoy tasty snacks. Everything draws to an exciting conclusion on Friday, August 4th, with a 6:00PM VBS cookout celebration for the entire family.

Parent/Guardian Name(s)(required)

Address(required)

City(required)

Zip code(required)

Home phone

Workcell phone(required)

email(required)

Emergency Contact Name(required)

Relationship to Child(required)

Emergency contact phone number (1)(required)

Emergency contact phone number (2)

Additional person who will pick your child up from VBS (1)

Additional person who will pick your child up from VBS (2)

If Other Church - please enter other home church

I give permission for my child to participate in Powhatan UMC VBS program. In the event of a medical emergency, I give permission for the staff of the VBS program to seek medical attention for my child.(required)

Signature (Full Name)(required)

Date(required)

Family Name(required)

Child (1) First Name(required)

Date of Birth(required)

Age(required)

Completed Grade for School year 2022-2023(required)

Does your child have any medical/special needs or food allergies? (Briefly describe course of action and symptoms)

Child (2) First Name

Date of Birth

Age

Completed Grade for School Year 2022-23

Does your child have any medical/special needs or food allergies? (Briefly describe course of action and symptoms)

Child (3) First Name

Date of Birth

Age

Completed Grade for School Year 2022-23

Does your child have any medical/special needs or food allergies? (Briefly describe course of action and symptoms)

Child (4) First Name

Date of Birth

Age

Completed Grade for School Year 2022-23

Does your child have any medical/special needs or food allergies? (Briefly describe course of action and symptoms)

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