frmYouth Registration

Westminster Presbyterian Church 2017 VBS Presents:
Digging for Treasure
"Parables Revealed
June 12 - June 16, 2017
9:15 a.m. - 12 noon
(for 3 year olds through completion of 5th grade)

* Indicates required field

Child's Name *

Age *

Birthdate *

Grade completed spring 2017 *

Street Address *

City, State, Zip *

Home Phone *

Parent Cell Phone *

Parent(s) Name *

Parent Daytime Phone *

Parent Email *

Parent(s) Name *

Parent Daytime Phone# *

Parent(s) Email *

In case of emergency contact: *

Daytime Phone # *

Allergies or other medical conditions *

Other people authorized to pick up your child (Name and Phone Number) **Child's teacher must receive a signed note in order to release child to someone other than parent. *

Home Church: *

You are welcome to serve on the VBS Team with your children. Please list the days that you can work. The days are Monday-Friday and Sunday. *

If you will need nursery care, please enter the age of your child. *

I understand that photographs of my children will be taken throughout the week and used by Westminster Presbyterian Church in promotional materials. Please contact us directly if this is a problem for your family. *

Yes No

Number of children attending from your family. (Please fill out a form for each child) *

For more information or to volunteer, please call Rev. Sarah Iliff McGill at (217) 522-4415.