Shake It Up!

July 17th - July 21st
6:30 - 8:30 pm
Ages 3 years old (Must be potty trained!) through 5th Grade
For more information, contact rebecca.grogan@fumctc.org
or call the church office at 972-625-1281.
Child's Name *
Parent/Guardian Name *
Address *
City, State, Zip *
Home Phone #
Cell Phone #
Work Phone #
Date of Birth *
month/day/year
Last School Grade Completed *
Home Church
Allergies/Special Medical Information
Emergency Contact 1 Name & Phone *
Emergency Contact 2 Name & Phone *
List the names of anyone who will pick up this child other than the parent/guardian.
PERSONS PICKING UP CHILDREN WILL BE REQUIRED TO SHOW VALID ID!
Would you like to help with VBS?
Note that the nursery is only available for VBS workers.
Yes  No
 
$5 Suggested Donation per Child / Maximum $10 Donation per Family
An email will be sent confirming your registration & allows the VBS Director to contact you if there is an issue with your registration. Please ensure that the email you enter is accurate.
Your Email: