ROAR VBS | Aldersgate United Methodist Church

Last Name - Student *

First Name - Student *

Address *

Address

Street Address 1

Street Address 2

City

State/Province

Zip/Postal

Country

Birth Date - Student

Parents Last Name *

Parents First Name *

Parent Home Phone *

Parent Cell Phone (Text OK) *

Parent Work Phone

Parent Email Address *

Email addresses will allow us to send a confirmation email of your student's registration as well as sending information about future Christian Education vents your child might enjoy attending.

Emergency Contact Name *

This person should be someone other than the parent listed above.

Emergency Contact Phone *

This person should be someone other than the parent listed above.

Allergies or other medical conditions, if none please enter NONE. *

Grade (Entering in September) *

T-Shirt Size *

Youth Sizes (YS - YXL) Adult Sizes (S-XL and other) **All Students will receive a shirt, we ask for a donation of $6.00 per shirt if you are able. If parents would like to order a shirt as well (cost will be $6.00 up to XL, $8.00 over 2XL) please indicate in the Other Section both sizes.

How did you hear of this event? *

Name of Church Affiliation, if any *

• I hereby grant / do not grant (please select one) permission for Aldersgate United Methodist Church to use pictures of my child on their website for information or promotional purposes. *

Grant

Grant for VBS Purposes Only. No Social Media or Promotional Purposes

Do not Grant

To grant permission enter the parent's name as signature *