Ages 4 years though 6th grade
Nursery through 3 years old with Adult Volunteer Only
For more information please contact Dawn Crews

Child's Name

Date of Birth

Does your child have any allergies?

Please list below

Please list allergies

Additional information/special needs:

Are you a member of Windcrest United Methodist Church

If you are not a WUMC member, are you a regular attendee?

If not, do you currently have a church?

If you currently have a church, where do you attendd?

Parents Names

Address

City, State

Zip Code

Mother's Cell

Father's Cell

email address

I would like to receive emails text massages with information about Children's events here at WUMC

Emergency Contact Name

If parent cannot be reached

Emergency contact phone number

Name and phone number

Person Authorized to pick up your child

Name and phone number

Person Authorized to pick up your child

EMERGENCY AND PHOTO RELEASE Signature and Date

As a participant in the Windcrest United Methodist Church Vacation Bible school, I understand that I give my permission to the sponsoring adults to have emergency medical care provided to my child(ren). Completion of this form releases Windcrest UMC and all persons participating in church sponsored activites from any and all liabiltily. I also understand that my child's photograph may be used in publications, electronic media or other forms of promotion, although no names will be used at any time.