Prayer 7:13 Prayer 713
North Highland United Methodist Church
Monday, April 23, 2018
Open Hearts, Open Minds, Open Doors
 
Cokesbury's Rollin River Rampage!
June 24-28 - 5:30PM - 8:00PM
VBS REGISTRATION FORM  - North Highland United Methodist Church

  

Parent/Guardian ____________________________________________
Address __________________________________________________
City __________________ State___________   Zipcode ____________
Home Phone ________Cell Phone _________ Cell Phone ____________
E-mail _________________________
Emergency Contact Name _____________________________________
Emergency Contact Numbers ___________________________________
 
Dismissal Information
Name(s) of person(s) who may pick up this child/children from VBS
 _________________________________________________________
 Transportation Needed:            Yes ____             No ____
 
 
Name _____________________________________________
Date of Birth __________ Grade Completed ____ Age ___
 Special Needs/Allergies/Medical Information______________________________________________________ _
Name ___________________________________________
Date of Birth __________ Grade Completed ____ Age ___
 Special Needs/Allergies/Medical Information______________________________________________________
Name _____________________________________________
Date of Birth __________ Grade Completed ____ Age ___
 Special Needs/Allergies/Medical Information______________________________________________________
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 Printed Name____________________________________
Parent Signature_______________________________________ 
Please print and return to North Highland UMC, 620 15th Ave. NE, Aberdeen, SD 57401