Parent/Guardian Name/s:

1) Childs Name: ___________________________________________ Age: ________

2) Childs Name: ___________________________________________ Age: ________ 3) Childs Name: ___________________________________________ Age: ________

4) Childs Name: ___________________________________________ Age: ________

Address:

Phone Number: Home ____________________________ Work:

Cell ______________________________

E-mail:

Church Home: Allergies/Medical Information/Other:

(Make checks payable to MUMC with VBS 2015 notation)

After the deadline, registration cost increases by $10/familyFor more information, contact Nancy Cooper at 443-3111 or nancy@moumc.org

For Office Use Only PD/recd Medical Vol Class CD

Registration Fee - $30-families of 2-3; $40-families of 4; $50-families of 5 or more includes T-shirt & CD if registered by May 31st. Earlybird deadline-June 28

T-shirt Size/s: (please put the number of shirts total you need in each category)_____ Youth Small _____ Youth Medium _____Youth Large _____ Adult Small

_____ Adult Medium Adult Large _____ Adult X-Large _____ Adult XX-Large

Family Registration Form Participants welcome of all ages

Nursery available for ages 2 and under

Missouri United Methodist ChurchVacation Bible School (VBS)

July 26-30, 2015 Optional free dinner: 5:30 p.m.

Program begins 6:00 p.m. New!

Evening VBS