Sango United Methodist Church
Vacation Bible School Registration

Child's Name:
Child's Address:
City:
State: Zip:
Child's DOB:
Child's Age (must be potty trained):
Last School Grade Completed for the 2006/2007 school year:
Child's Home Church:
Please list any comments or health concerns/allergies of which the church should be aware:

Name of Parent(s)/Guardian(s):
Parent/Guardian Home Phone Number:
Parent/Guardian Cell Phone Number:
Parent/Guardian Email address:

First Emergency Contact Name:
First Emergency Contact Phone Number:
Second Emergency Contact Name:
Second Emergency Contact Phone Number:

Please list the names of those who may pick up this child from VBS each day:

List only those siblings that will be attending VBS:

Note: Nursery will be available only for children of VBS volunteers.