Theme image

Registracion del Participante

Go Back

Medina United Methodist Church

Location

4747 Foote Road

Medina, OH 44256

Map It

Contact Wendy Norris:

330-725-4943

wendynorris@medinaumc.com

Primero, cuéntenos sobre usted:

Información de los Padres

Nombre

This field is required.

Apellido

This field is required.

Correo Electrónico

This field is required.

Dirección 1

This field is required.

Dirección 2

This field is required.

Ciudad

This field is required.

Estado/Provincia

This field is required.

ZIP/Código Postal

This field is required.

Teléfono de Contacto 1

This field is required.

Teléfono de Contacto 2

This field is required.

Nombre del Contacto de Emergencia

This field is required.

Relación del Contacto de Emergencia

This field is required.

Teléfono del Contacto de Emergencia

This field is required.

Nombre de recogida alternativo

This field is required.

Teléfono de recogida alternativa

This field is required.

Afiliación de la iglesia local

This field is required.

Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Cuéntanos sobre tu participante

Nombre

This field is required.

Apellido

This field is required.

Grado Entrando

This field is required.

Género

This field is required.

Fecha de nacimiento

This field is required.

Alergias

This field is required.

Preocupaciones Médicas

This field is required.

May we take pictures of the child for church use?

This field is required.

¿Tienes amigos con los que te gustaría estar juntos? Haremos todo lo posible para juntar a los amigos seleccionados en el mismo grupo, pero no podemos prometer que todas las solicitudes serán posibles.

Amigo 1 Nombre

This field is required.

Amigo 1 Apellido

This field is required.

Amigo 2 Apellido

This field is required.

Amigo 2 Nombre

This field is required.

Only pre-purchased t-shirts will be ordered. The price is $7.75 for youth t-shirts and $12.00 if ordering an adult-sized t-shirt. Please use the link to order. THE PURCHASE DEADLINE IS JUNE 28.

Child's VBS t-shirt

Child t-shirt size

This field is required.

— or —