VBS 2023 Registration VBS Registration 2023 Hidden1st Child Child's Name(Required) First Last Gender(Required) Male Female Birth Date(Required) MM slash DD slash YYYY Age(Required) Min. 4 years old; Max. 12 years oldGrade Entering (this year)(Required)Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade1st Child's T-Shirt Size(Required)Child S (Size 6-8)Child M (Size 10-12)Child L (Size 14-16)Cost $10.00 eachHome Address(Required) Street Address Address Line 2 City ZIP Code Mailing Address (If different than street address above) Mailing Address Mailing Address (line 2) City ZIP Code Parent/Guardian #1 Name(Required) First Last Parent/Guardian #1 Phone(Required)Parent/Guardian #1 Email(Required) Parent/Guardian #2 Name First Last Parent/Guardian #2 PhoneParent/Guardian #2 Email Alternate Emergency Contact(Required) First Last In event Parent/Guardian #1 and/or #2 can’t be reached.Emergency Contact's Phone(Required)Medical Alerts / Allergies (medical alerts)If multiple children registered, note name of child for each alert listed. NOTE: Connect UMC nor it’s volunteers are medical personnel. Information is so we are aware for precautionary reasons only.Person responsible for pickup after VBS?(Required) Anything else we should know?Register Additional Child? Yes “Additional Child” assumes same Parent/Guardian, address, Emergency Contact, Pickup Person as first child registered. If different, please register using new form.2nd Child's Name(Required) First Last 2nd Child's Gender(Required) Male Female 2nd Child-Birth Date(Required) MM slash DD slash YYYY 2nd Child's Age(Required) Min. 4 years old; Max. 12 years old2nd Child-Grade Entering (this year)(Required)Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade2nd Child's T-Shirt Size(Required)Child S (Size 6-8)Child M (Size 10-12)Child L (Size 14-16)Cost $10.00 eachRegister 3rd Child? Yes “Additional Child” assumes same Parent/Guardian, address, Emergency Contact, Pickup Person as first child registered. If different, please register using new form.3rd Child's Name(Required) First Last 3rd Child's Gender(Required) Male Female 3rd Child-Birth Date(Required) MM slash DD slash YYYY 3rd Child's Age(Required) Min. 4 years old; Max. 12 years old3rd Child-Grade Entering (this year)(Required)Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade3rd Child's T-Shirt Size(Required)Child S (Size 6-8)Child M (Size 10-12)Child L (Size 14-16)Cost $10.00 eachRegister 4th Child? Yes “Additional Child” assumes same Parent/Guardian, address, Emergency Contact, Pickup Person as first child registered. If different, please register using new form.4th Child's Name(Required) First Last 4th Child's Gender(Required) Male Female 4th Child-Birth Date(Required) MM slash DD slash YYYY 4th Child's Age(Required) Min. 4 years old; Max. 12 years old4th Child-Grade Entering (this year)(Required)Pre-KKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade4th Child's T-Shirt Size(Required)Child S (Size 6-8)Child M (Size 10-12)Child L (Size 14-16)Cost $10.00 eachTotal Quantity T-ShirtsTotal T-Shirts should equal same number of children registeredRegistration Deadline Note Online registration deadline is July 14, 2023 to secure your child’s VBS T-Shirt. You may still register after that date (online or walk-in), but t-shirts not guaranteed. Late registration may pay for t-shirts on 1st day of VBS if one is available.Click "Submit" below to complete VBS 2023 registration Please verify all information above is correct before selecting “Submit”. Once “Submit” button is pressed, you will be re-directed to our secure payment platform in order to pay the total t-shirt fee. (When on secure payment site, select “VBS 2023”, enter amount due ($10.00 x # children registered=total due), select “One Time” payment option, and complete form of payment)
