VBS REGISTRATION 2008
June 16th-20th, 9am to noon
Ages: 4 years to rising 6th grade
Please fill out one registration per child
Name __________________________________________________________________________
Address _________________________________________
Phone ________________________
City _____________________________ State ______________ zip ______________
Email Address:_______________________________________________
Do you prefer to get information by email? (circle one) YES NO
Age as of June 16th: _____________ Birthdate ____________________
school grade/ preschool class as of August 25, 2008: ______________ __________
Parents Name _________________________________ Daytime phone __________________
Evening Phone Numb er:_____________________________
Doctor's name _________________________________ phone number ___________________
Person to contact in case of emergency______________________ Phone number:________________________
relationship ________________________
alternative contact:_______________________________ phone number:__________________________________
List name of persons who may pick up this child from VBS each day:
_______________________________ ______________________________
Allergies or medical problems: _________________________________________________________________
Name of friend your child would like to be placed with (if applicable):__________________________________
Siblings attending VBS:_____________________________ ______________________________________
Are you a member of Matthews Presbyterian Church? Yes No
There is no charge for VBS. We do ask that your child participate in our mission project. You will receive further information about our project before the first day. You can also support VBS by helping with:
________ Set up before opening day
________ Work in the teacher's nursery
________ Send in items for snack
________ volunteer for VBS (circle one) All Days Partial Time
Preferred position________________________ Days Available ________________
