North Highland United Methodist Church
Friday, May 24, 2019
Open Hearts, Open Minds, Open Doors

Printable VBS Registration

VBS REGISTRATION FORM - North Highland United Methodist Church
To Mars and Beyond
June 23 -27    5:30PM - 8:00P
*Child #1   Name_____________________________________________________________________
     Grade Completed __________ Age ______
     Special Needs/Allergies/Medical ____________________________________________________
*Child # 2   Name ____________________________________________________________________
      Grade Completed _________ Age ______
Special Needs/Allergies/Medical _______________________________________________________
Home Church: North Highland UMC ____    Other_______________________________________
Parent/Guardian _____________________________________________________________________
     Address ________________________________City_________________State_____ Zip ________
     Phone 1 ___________________    Phone  2_______________________Text Yes___ No ____
     E-mail _________________________
Emergency Contact Name  if other than parent ___________________________________________
Emergency Contact Phone ___________________________________________
Name(s) of person(s) who may pick up this child/children if other than parent/guardian
USE OF PICTURES: Consent is hereby granted to North Highland United Methodist Church for the use of news releases, photographs, digital images, social media, and television participation involving my child individually or in a group. These images may appear in various publications, presentations, church web pages, social media and/or television broadcasts. This authorization will remain in effect until further notice to the contrary by the parents/guardian or until your child turns eighteen.
Picture Consent Authorized YES_____ NO_____
Parent/Guardian Printed Name___________________________________________
Parent/Guardian  Signature_______________________________________________
           Please return to North Highland UMC    620 15 Ave. NE, Aberdeen, SD 57401