Register Online

VBS 2008 - Johnson City Primitive Methodist Church

Register Online

NOTE: Registration form best viewed with Mozilla Firefox browser,
but still compatible with Internet Explorer and other web browsers.

NAME of Parent or Guardian completing this Registration Form
How many children are you registering:
NAME(s) of Child(ren)
Mailing Address
City, State, Zip Code
Home Phone #
Email Address
Date(s) of Birth (in same order as names, please)
School Grade(s) Completed (in same order as names, please)
Do you need NURSERY care for infant(s) under age 2?
Does child currently attend any church?
If YES, please state church name.
Attended VBS at JCPM Church before?
Transportation to VBS
If child is Dropped Off, who is authorized to Pick him/her Up?
Emergency Contact Name (if different than parent above)
Emergency Contact Phone # (if different from home phone above)
-------------------------------------------------------------- Now that we are serving LUNCH, the next question below is VERY IMPORTANT - please complete for your child's safety!
Does child have ANY food allergies and/or health concerns of which VBS Staff should be aware?
ANY ALLERGIES (especially food-related) and/or other health considerations - IMPORTANT! List each child as necessary. (unlimited space provided) --------------------------------------------------------------
PARENT or GUARDIAN - PLEASE CHECK HERE: As parent/guardian of this child, I release the Johnson City Primitive Methodist Church and all volunteers associated with the Vacation Bible School program from any and all liability to the above named child during his/her attendance at all VBS meetings. Should any injury occur, I give my permission for first aid treatment to be given and for any doctor or hospital personnel to render emergency medical treatment as is deemed necessary.
How did you find this website?
If OTHER, please specify:
* PLEASE CHECK ALL THAT APPLY * (below):
I heard about VBS 2008 because I attend this church
I was referred to VBS 2008 by a friend or relative
I received a VBS 2008 invitation in the mail
I received a VBS 2008 flier through my child's school
I saw VBS 2008 signs posted outside the church
I saw VBS 2008 yard signs posted around the neighborhood
I was VBS 2008 publicized in the Press or other media
I first heard about VBS 2008 by finding this website

IMPORTANT!

After submitting form, look for a registration confirmation email in your inbox. If you do not receive one within 24 HOURS, please return to this page to send an email to the Director (click link below if needed). Thank you!

E-mail:

Michael Rushmer

VBS 2008 Director

www.PMVBS.com
(c) 2008 Johnson City Primitive Methodist Church

Sharing God's love in Christ to you and through you to the world.

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VBS 2008 - Johnson City Primitive Methodist Church
Vacation Bible School - Johnson City, New York
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