White Bluff United Methodist Church
Sunday, June 20, 2021

 

 

 

 White Bluff United Methodist Church

 2021 Vacation Bible School Presents

  “Adventure Island"


 
June 21-24, 2021

 

 

 

 

 

 

 

 

To sign your child up, please fill in the fields below and click "Submit".  (If you have more than 4 children to sign up, please submit more than one form.)

  

 (Entries marked with a "*" are required)

 

Child 1 Name / Age.........................*..  
Child 2 Name / Age............................  
Child 3 Name / Age............................  
Child 4 Name / Age............................  

Parent / Guardian name..................*..
      Street Address............................*..
      City   State     Zip........................*..   

Email address...................................*..
Phone number
...(home) ..................*..
Phone number...(cell) .........................
 
Number of family members participating in VBS .....
Will parents be helping with VBS?....(Y/N)...............
                                     If so, Where?...................... 
 
Home Church .................................... 
 
 
If your child has any special needs or issues (allergies, medical conditions, etc.) we need to be aware of, please provide details in the area below.
 
Emergency Contact Information:
      Name............................*.. 
      Phone...........................*.. 
      Relationship to child..*... 
 
 Click the Submit button to complete your registration.