HUMC - Vacation Bible School

To register your child for VBS, please complete the form below and click the “Submit Registration" button at the bottom of the page. If you would like to help with VBS in any way, please indicate so on the form. Child care is available for those who help with VBS.

Child's Information
First Name
Last Name
Parent's Names
Address
City
State
Zip Code
Birth Date
Gender
Home Phone
Conditions which may limit activity

Food allergies

Animal/insect allergies

May we use bug/insect repellent on your child? YesNo
If your child has special needs of any kind, would you like an adult shadow? YesNo

Emergency Contact Information
First Name
Last Name
Phone Number
Alternate Phone

Alternate Emergency Contact Information
First Name
Last Name
Phone Number
Alternate Phone

Who can pick up your child


Email Address *
I understand that in the event medical intervention is needed, every attempt will be made to contact the persons listed on this form. In the event I cannot be reached in an emergency, I hereby give permission to the physician or dentist selected by the activity leader to hospitalize, to secure medical treatment and/or to order an injection, anesthesia, or surgery for my child as deemed necessary. I understand that my insurance coverage for my child will be used as primary coverage in the event medical intervention is needed. Coverage by Huntersville United Methodist Church through its accident policy will be used as a backup for what my family’s insurance does not cover. I understand all reasonable safety precautions will be taken at all times by Huntersville United Methodist Church and its agents. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Huntersville United Methodist Church, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form.
I Agree to the release statement above. *

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Preschool Starts - Easing In
September 07, 2010 (9:15 am)
Staff Meeting
September 07, 2010 (10:00 am)
Nifty Needles
September 07, 2010 (10:00 am)
Food Pantry
September 07, 2010 (10:00 am)
Healthy Living
September 07, 2010 (6:30 pm)

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