VBS Registration

June 14-18, 9:00 AM - Noon
@ Saron UCC (440 1st St. NE)
Joint VBS of Saron UCC, Linton First United Methodist Church, Linton Assembly of God, & Salem UCC Wesphalia

* Indicates required field

Child's Name *

First

Last

Gender *

Male Female

Child's Age *

Child's Date of Birth *

Last School Grade Completed *

Child's T-Shirt Size *

Name of Parent(s) *

Street Address *

Home Phone Number *

Parent/Caregivers Cell Phone Number *

Email *

Home Church *

Please List Any Allergies or Medical Conditions *

In Case of Emergency, Contact *

Phone Number for Emergency Contact *

Relationship to Child *

Submit