VBS Registration Form
VBS Registration Form
Parent's First Name  * 
Parent's Last Name  * 
Address, City, Zip Code  * 
Church Affiliation  * 
Contact Phone Number  * 
Emergency Contact  * 
Emergency Contact Phone Number  * 
Your Email Address  * 
How many children will attend?  * 
Please list Child/Children's information below. Entering kinder - finishing 5th grade only. Please include First and Last name, Gender, Age, Date of Birth, Grade Completed, list of Allergies/Medical conditions. Please list each child in a new line.
If your child wants to be with a friend (same grade only) forms must be turned in by June 1, 2016.
Health Release: In the event of an emergency and in my absence, I hereby give consent to any of the Coker UMC staff to seek emergency medical treatment for child(ren) named above. While understanding that all reasonable safety precautions will be observed, I understand the possibility of unforeseen hazards and the inherent possibility of risk. I voluntarily agree not to hold legally liable Coker UMC, any of its employees, volunteers, or other representatives associated with providing or arranging for emergency medical treatment for my child(ren).
Signature (Parent/Guardian)  * 
Photography Waiver: I understand Coker UMC from time to time produces material about its programs. I understand that my child(ren) named on this form may be included in video tape or photographs taken at the church or church activities. I herby give my consent for photographs and/or videos to be taken of my child(ren) to be used for church publicity.
Signature (Parent/Guardian)  * 
If your child participates in VBS, you or a member of your family is asked to volunteer in some way. If you are unable to volunteer during the week of VBS please contact Cheryl Kendall in the Children's Ministries office at 494-3455. (There are many tasks to be done before the BIG Week) Volunteers who sign up to be crew leaders are required to attend a child/youth protection class; this is renewed every 4 years. The class will be offered Mondays April 25 and May 2 at 6:00 pm. You only need to attend one class.
Below are the areas where you can volunteer at VBS. Circle each one that you would be interested in volunteering. (Note: There's a possibility parents won't be with their child.)
Crew Leader
Activity helper
General Help  * 
If you can't volunteer everyday, what days can you volunteer? (example: mon, tues, wed, thurs) Karina Silva will call or email to let you know where you will be volunteering.
If you are volunteering on campus during VBS, a small version of VBS will be provided for 3 and 4 year olds and child care for 3 months - 2 years. Please list their information below. Include the following information for each child (First and Last name, Age, DOB, Allergies/Medical)
Please mark the size and how many t-shirts you would like to purchase. T-shirts are $7.00 each.
Child T-shirt X-Small
Child T-shirt Small
Child T-shirt Medium
Child T-shirt Large
Adult T-shirt Small
Adult T-shirt Medium
Adult T-shirt Large
Adult T-shirt X-Large
If you would like VBS music, select how many below. Music will be available to purchase during VBS, but in limited quantities. Order Early! CD's are $6.00 each and DVD's $16.00 each
CDs - $6.00 Each
DVDs are $16 each
Please type in the box to the right »  * 
Total $
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