2026 PUMC VBS Registration

8:45 AM until 12:15 PM.
For children 4 years old – 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 Sunday, August 2nd, at our 10:30AM Worship Service with refreshments and fellowship afterword.

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Parent/Guardian Name(s)

Address

City

Zip code

Home phone

Workcell phone

Emergency Contact Name

Relationship to Child

Emergency contact phone number (1)

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)

Church Affiliation

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. I assume all risk of personal injury, sickness, death, damage, and expense as a result of my minor child's participation in the VBS program and release Powhatan UMC and its trustees, directors, employees and volunteers from any and all liability.

Signature (Full Name)

Date

I give permission for images of my child captured during the VBS activities through video, photo, and digital camera to be used solely for the purposes of Powhatan UMC promotional materials.

Family Name

Child (1) First Name

BoyGirl

Date of Birth

Age & Shirt Size

Completed Grade for School year 2024-2025

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

Child (2) First Name

Boy/Girl

Date of Birth

Age & Shirt Size

Completed Grade for School Year 2024-25

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

Child (3) First Name

Boy/Girl

Date of Birth

Age & Shirt Size

Completed Grade for School Year 2024-25

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

Child (4) First Name

Boy/Girl

Date of Birth

Age & Shirt Size

Completed Grade for School Year 2024-25

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

Thank you for your response. ✨

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