Vacation Bible School 2008

Vacation Bible School 2008 registration
Please fill out and submit the following form for up to four children from the same household. Please submit a separate form for children from different households. After you have submitted this form, you will have an opportunity to pay on-line with a credit card through PayPal. You may also pay by check..

1. Child's information: (See the Tip in the box at right.)

Name of Child (First, Middle, Last):

Birth date: Age:

Grade: Male Female

Shirt Size

Please list all medical conditions limiting child’s activity (I.e. food allergies, medication allergies, and physical limitations).

I would like Extended Care for my child from 12:00 noon to 6:00 p.m. at $15 per day. Please check all days that apply:
Monday Tuesday Wednesday Thursday Friday

Address of children registered on this form (Please submit a separate form for children living at a different address.)
Street:
City, State Zip:

Skip to Mother's Information section if registering only one child.

2. Register additional children in the same household:

Name of Child (First, Middle, Last):

Birth date: Age:

Grade: Male Female

Shirt Size

Please list all medical conditions limiting child’s activity (I.e. food allergies, medication allergies, and physical limitations).

I would like Extended Care for my child from 12:00 noon to 6:00 p.m. at $15 per day. Please check all days that apply:
Monday Tuesday Wednesday Thursday Friday

Skip to Mother's Information section if registering only two children.

Name of Child (First, Middle, Last):

Birth date: Age:

Grade: Male Female

Shirt Size

Please list all medical conditions limiting child’s activity (I.e. food allergies, medication allergies, and physical limitations).

I would like Extended Care for my child from 12:00 noon to 6:00 p.m. at $15 per day. Please check all days that apply:
Monday Tuesday Wednesday Thursday Friday

Skip to Mother's Information section if registering only three children.

Name of Child (First, Middle, Last):

Birth date: Age:

Grade: Male Female

Shirt Size

Please list all medical conditions limiting child’s activity (I.e. food allergies, medication allergies, and physical limitations).

I would like Extended Care for my child from 12:00 noon to 6:00 p.m. at $15 per day. Please check all days that apply:
Monday Tuesday Wednesday Thursday Friday

3. Mother's information:

Mother's name:

Mother's Address: Same as child's
Street:
City, State: Zip:
 

Mother's E-mail address:

Mother's home phone:
Mother's work phone:
Mother's mobile phone:
(Please include area code)




4 Father's information:

Father's name:

Father's Address: Same as child's
Street:
City, State: Zip:
 

Father's E-mail address:

Father's home phone:
Father's work phone:
Father's mobile phone:
(Please include area code)




5. Emergency information:

Emergency Contact:
(Name, Relation, and Phone Number)

Health Care Provider and Phone:

 

7. Pickup arrangements:

Please list all persons and their relationship who are authorized to pick up your child(ren):


Please be aware that the adults listed above are the only persons to whom we will release your child.

9. Submit your registration: Please check your information and then click the submit button below:

 

 

Power Lab

Tip: use the "Tab" key or the mouse to move between boxes. Using the enter key will "submit" the form. If you accidentally submit the form before completing it, just use the "back" button on your Web browser to return to the form.

For more information, please contact:

Jennifer Olinger
Assistant to Education and Outreach
E-mail:  JOlinger@fumcsd.org
619-297-4366 ext.109
First United Methodist Church of San Diego, 2111 Camino del Rio South, San Diego, California 92108  •  619-297-4366  •  mail@fumcsd.org
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