Vacation Bible School 2017

Discover God's good gifts at out Peruvian themed camp July 17-21!

  • Who: Children ages 3 - entering 6th grade.
  • What: Crafts, music, stories, snacks, and friends - old and young!
  • Where: Edmonds United Methodist Church, 828 Caspers St., Edmonds, WA 98020
  • When: 9am - noon plus optional extended program from noon - 3pm for kids entering grades 3 - 6
  • Cost: $65. VBS and optional extended program totals $100.

Fill out the form below to register!

VBS Registration


Child's Name:*
Birth date:*
Child's Gender:*
School Child Attends:*
Grade of Child in Fall 2017:*
Friend Child is Attending with:*
Allergies:
Special Needs:
T-Shirt Size:*

Please fill out the following information if you are registering a second child.

Second Child's Name:
Birth date of Second Child:
Second Child's Gender:
School Second Child Attends:
Grade of Second Child in Fall 2017:
Friend Second Child is Attending with:
Allergies of Second Child:
Special Needs of Second Child:
T-Shirt Size for Second Child:

Please fill out the following information if you are registering a third child.

Third Child's Name:
Grade of Third Child in Fall 2017:
Third Child's Birth date:
Third Child's Gender:
School Third Child Attends:
Friend Third Child is Attending with:
Allergies of Third Child:
Special Needs of Third Child:
T-Shirt Size for Third Child:
Parental Information
Parent (1) Name:*
Address:*
Parent 1 Phone #:*
-
Parent 1 Email:*
Parent (2) Name:
Parent (2) Address:
Parent 2 Phone #:
-
Parent 2 Email:

Emergency Contact Name:*
Who has permission to pick up your child from VBS?
Phone:*
-
Who IS NOT allowed to pick up your child from VBS?
Release Information:
PHOTO RELEASE:
I hereby give permission for my child to have my childs' photo used on the EUMC website or in the publications of EUMC.:
*
MEDICAL RELEASE:
I hereby give permission for my child to receive emergency treatment (CPR, First Aid) while in the care of EUMC, if necessary. If I can't be contacted, I authorize and consent to medical, surgical, and hospital care, treatment and procedures to be performed for my child by a licensed physician, health care provider, hospital, EMS or aid car attendant when deemed necessary. I waive my right of informed consent to such treatment. I also give permission for my child to be transported by ambulance or aid car to any emergency center for treatment. The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in connection with such medical and dental services rendered to the aforementioned child(ren) pursuant to this authorization.
*
Select the Bubble to the right if you're registering for the 9:00a.m. - 12:00p.m. VBS program:(1)
Select the Bubble to the right if you're registering for both the 9:00a.m. - 12:00p.m. and extended program, 12:00 - 3:00p.m. VBS program:
Total: