Bumc Vbs Registration Form

Batavia United Methodist Church Vacation Bible School Registration

When: July 27 - 31, 9am – noon Who: Children age four (as of 9/1/09) through rising fifth graders (Children must be potty-trained) Cost: $20 per child; Three or more per family: $50 total REGISTRATION DEADLINE IS July 12. FORMS RECEIVED AFTER July 12 WILL INCURE A $5 LATE FEE. REGISTRATION IS NOT COMPLETE UNTIL SIGNED FORM AND FEE IS SUBMITTED. Child’s Name: ____________________________________________

Age: ____________

Date of Birth: ____________________________________ Grade for fall ’09: _____________ Street Address: ________________________________ City: ___________________________ Parent/Guardian: _______________________________________________________________ Home phone: _______________________Work/Cell phone: ___________________________ Emergency Contact(s): (other than parents/guardian) Name: ___________________________ Name: ___________________________ Physician: _______________________

Phone: _____________________ Phone: _____________________ Phone: _____________________

Allergies/Physical/Dietary Concerns: _______________________________________________ To further enhance this family approach, we are encouraging parents/guardians to join their child(ren)’s tribe during the week. Please indicate which days you plan to visit Camp Edge: _____ Monday _____ Tuesday

_____ Wednesday _____ Thursday

_____ Friday

Child’s Home Church: _________________________________

(Over please!)

OTHER: VBS t-shirts and a CD of the music the children will learn during VBS are available for purchase. If you would like to purchase either or both items, please indicate on the “Registration Checklist” below. These items are OPTIONAL. PLEASE MARK YOUR CALENDARS: An ice cream social is scheduled for Thursday, July 30, for all VBS participants and their families. Please plan to join us as we celebrate with our “Camp Edge.” ******************************************************************************* In the event of an emergency, we will attempt to contact you. If we are unable to reach you, your signature below indicates that you grant the Director of Christian Education, or her designee, permission to seek medical treatment for your child and indicates your consent for your child to receive any medical treatment deemed necessary by the examining physician. It further indicates that you have full financial responsibility for any such care. I also give permission for my child to be photographed by Batavia United Methodist Church for a closing program slide show and promotional photos for future Bible schools. Parent/Guardian: __________________________________________

REGISTRATION CHECKLIST

Registration

$20.00

T-shirt

$10.00

Circle size

CD (optional)

XS

S

M

$

L

XL

$5.00

$ $

TOTAL

(Make checks payable to Batavia UMC – VBS in Memo)

$

Registration Fee paid _________