Registration deadline: June 30, 2017!

Welcome to Vacation Bible School Registration page

(for students finishing preschool through 5th grade)

Cost is $2/child/day or  no more than $25/family/week.

Samples

  • 1 child x 3 days = $6
  • 1 child x 5 days = $10
  • 2 children x 5 days = $20
  • 3 children x 4 days = $25
  • 4 children x 5 days = $25

Upon completion of this form, you will be redirected to PayPal. If you do not wish to use PayPal (you don’t need an account, just click on  “Pay with Debit or Credit Card“), then simply close the window. Drop your payment into the offering plate and indicate VBS Registration on the memo line or mail it into:

Community UMC
Attn: Dawn Roth
20 N Center
Naperville, IL 60540

Fields marked with * are required

Your Name* (first and last)
Your Email*

Child's Information

 
Child's Name* (first and last)
Grade Completed*
Birthday* (mm-dd-yyyy)

Age*

Contact Information

 
Parent's Name* (first and last)
Parent's Name (first and last)
Home Address
City, State
Home Phone*
Alternate Phone

Health Information

 
Food Allergies*
YesNo
If yes, please list

Medical Concerns*

YesNo
If yes, please explain:

Siblings Attending Vacation Bible School

1. Name:

Age

2. Name:

Age

3. Name:

Age

4. Name:

Age

Church Information

 
Church Affiliation

Church Membership

T-Shirts

 
Child One*

Child Two


Child Three


Child Four

Pick Up

 
[please indicate below who may pick up your child]
1. Name*

Phone*

2. Name

Phone

Authorization

 
Do you authorize Community UMC to photograph/film your child with activities associated with this Vacation Bible School program?*
YesNo  

Parent Signature

 
[your electronic signature is your consent for your child to participate in Vacation Bible School and that all the above information is accurate.]*

Clicking the button below submits your application and redirects you to PayPal. If you wish to pay using PayPal, please select either 1 or 2 in Quantity (1=one child, 2=family) on the PayPal screen. If you do not wish to use Paypal, simply close the window!