VBS Registration

Parent/Guardian/Adult Name

Address City

Zip Code

Email Address. This will send a Copy of this form to you

Phone Numbers: Home Cell Work

Emergency Contact Phone Number

Home Church

Dismissal Information (Who may pick up these children?)

Child #1 First name Child's Last Name

Date of Birth Age Last School Grade completed

Is He/She Allergic If so to What?

Does He/She have a Medical Condition If So What?

Child #2 First name Child's Last Name

Date of Birth Age Last School Grade completed

Is He/She Allergic If so to What?

Does He/She have a Medical Condition If So What?

Child #3 First name Child's Last Name

Date of Birth Age Last School Grade completed

Is He/She Allergic If so to What?

Does He/She have a Medical Condition If So What?

Child #4 First name Child's Last Name

Date of Birth Age Last School Grade completed

Is He/She Allergic If so to What?

Does He/She have a Medical Condition If So What?

May Sunset United Methodist Church use your child(ren)'s photos on its website, newsletter, and bulletin boards?

Additional Comments

Do not click "Submit Registration" until after the information is entered.

709 Allendale

Pasadena, Texas 77502

(713) 473-7657