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Registracion del Participante

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St. Andrew United Methodist Church

Location

4703 N. 50 W.

West Lafayette, IN 47906

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Contact Danielle Buckley:

765-497-7755

danielle@andrew-umc.org

Primero, cuéntenos sobre usted:

Información de los Padres

For St. Andrew UMC VBS we will be capturing pictures of the event. If you would like for your child to not be photographed there will be a form you can fill out during VBS check-in on June 17th. This form can be requested at the check-in desk.

Nombre

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Apellido

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Correo Electrónico

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Dirección 1

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Dirección 2

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Ciudad

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Estado/Provincia

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ZIP/Código Postal

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País

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Teléfono de Contacto 1

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Teléfono de Contacto 2

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Nombre del Contacto de Emergencia

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Relación del Contacto de Emergencia

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Teléfono del Contacto de Emergencia

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Nombre de recogida alternativo

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Teléfono de recogida alternativa

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Nombre alternativo de recogida 2

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Teléfono alternativo de recogida 2

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Afiliación de la iglesia local

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Comentarios

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Cuéntanos sobre tu participante

Nombre

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Apellido

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Grado Entrando

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Género

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Fecha de nacimiento

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Alergias

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Preocupaciones Médicas

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¿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

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Amigo 1 Apellido

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Amigo 2 Nombre

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Amigo 2 Apellido

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Amigo 3 Nombre

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Amigo 3 Apellido

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Comentarios

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