(PLEASE USE ONE FORM PER CHILD)

 VACATION BIBLE SCHOOL

JUNE 28-July 2, 2010

9:00 – 12:00 am

Church performance:  Sunday, July 4 @ 9:15 a.m.

Grace United Methodist Church
318 N. Center St., Geneseo
Phone: 944-4208

Child’s Name_________________________________________________Birthdate__________

Parent Name(s)_____________________________________________________________

Address___________________________________________________________________

Phone (during VBS time) _____________________   Cell Phone ____________________

Home e-mail address ________________________________________________________

Church usually attended  ______________________________________________________

Any allergies/medical problems Staff should be aware of _________________________________

CIRCLE ONE CLASS:

Entering in the Fall 2010:     1st Grade        2^nd Grade       3^rd Grade          4^th Grade       5^th  Grade        6^th Grade

If you are volunteering to help with VBS and  have children younger than 1st grade, please make a note on this form or contact the VBS directors/church for your child’s participation in VBS.

CIRCLE ONE SHIRT SIZE     ______ $5 (per) T-shirt Attached (ages 0-3 not included)

 (checks made payable to Grace United Methodist Church)

 Youth S           Youth M                Youth L            Adult S               Adult M          Adult L

Optional:  ____ Yes, I’d like to participate in the free lunch following each day of VBS (12:00-12:45)

(Donations accepted, but not required for participation)

My signature here gives Grace UMC permission to use pictures of the child listed on this form.  Pictures may appear on the church web site and/or print media.

                   Parent/guardian signature  ________________________________________________

 Please return form to Church office