Chestnut Memorial UMC Vacation Bible School Registration Form
(One form per child, please)




  1. (must have been born on or before September 30th, 2015, and be potty trained)
  2. (street, city, state, zip code)
  3. (to pick up a child one must be listed on this form and show a picture ID)
  4. (may we have permission to photograph your child?)
  5. (digital signature is required)
  6. Please Complete This Form by July 3rd. Thank You.


  7.  
Note: Your information will remain confidential.