VBS 2023 Registration | St Lukes United Methodist Church

WHAT: Pets Unleashed VBS

WHEN: Wednesday, June 14, 2023

TIME: 5:00 pm to 8:15 pm
(Light dinner will be served for children and families @5PM)

WHERE: St. Luke's UMC at 206 Scheurmann, Essexville, MI

AGES: Pre-school through 6th grade

Deadline to register: June 12, 2023

Child's Name *

First

Last

Child's Age *

Child's Birthday *

Last School Grade complete *

Kindergarten, 1st, 2nd, 3rd, etc.

Parent's Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Parent's Email

Email

Confirm Email

Home Phone *

Cell Phone

Preferred method of contact

Phone call
Email

Please indicate how you would like to be contacted in case of questions.

Home Church

Allergies or other medical conditions

Emergency Contact Name *

Emergency Contact Phone *

Relationship to Child *

Parent, grandparent, caregiver, etc.

Photo Release for this event

Yes, it's ok to use photos of my child.
No, please do not use photos of my child.
I am not the legal parent or guardian

I, the legal parent or legal guardian, of this child, grant St. Luke's United Methodist Church, my permission to use the photographs taken at this event, for any legal use, including but not limited to publicity, illustration, and web content.

Questions/Notes/Comments

Any questions or comments you would like to add?