WORTHINGTON UNITED METHODIST CHURCH
614-885-5365
Worthington United Methodist Church
600 High Street
Worthington, OH 43085
614-885-5365
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VBS
VBS: Camp Edge Registration Form
form in .pdf
August 10-14, 2009 5:30-8:30pm
On this form
:
School Age Kids
: Give Grade Completed in June 2009.
Preschool Children must be 3 by September 30, 2009
: Give current age.
Childs Information
Child's Name
T-Shirt Size
Childs: sm
med
 - lrg
or
Adults: sm
- med
- lrg
- xlrg
Grade
Completed
in June 2009
:
Current Age
:
Allergies
:
YES
NO
If YES Type of Allergy
:
2nd Childs Information
Child's Name
T-Shirt Size
Childs: sm
med
 - lrg
or
Adults: sm
- med
- lrg
- xlrg
Grade
Completed
in June 2009
:
Current Age
:
Allergies
:
YES
NO
If YES Type of Allergy
:
3rd Childs Information
Child's Name
T-Shirt Size
Childs: sm
med
 - lrg
or
Adults: sm
- med
- lrg
- xlrg
Grade
Completed
in June 2009
:
Current Age
:
Allergies
:
YES
NO
If YES Type of Allergy
:
4th Childs Information
Child's Name
T-Shirt Size
Childs: sm
med
 - lrg
or
Adults: sm
- med
- lrg
- xlrg
Grade
Completed
in June 2009
:
Current Age
:
Allergies
:
YES
NO
If YES Type of Allergy
:
5th Childs Information
Child's Name
T-Shirt Size
Childs: sm
med
 - lrg
or
Adults: sm
- med
- lrg
- xlrg
Grade
Completed
in June 2009
:
Current Age
:
Allergies
:
YES
NO
If YES Type of Allergy
:
Medical Information
Other Medical Information of which we should be aware
:
Parent Information
Parent / Guardian Name
:
Address
:
(line 2)
City
:
Zip
:
Phone
:
Cell Phone
:
Email
:
Other Contact Information
In case we are unable to reach you:
Contact Name
:
Phone
:
Cell Phone
:
Relationship to child
: