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Participant Registration

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Registro en Español

Venice Free Methodist Church

Location

4871 S. Centinela Ave.

Los Angeles, CA 90066

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Contact Ken Koshimizu:

310-367-0388

kids@venicechurch.org

First, Tell Us About Yourself:

Parent Information

Please note:

Photographs of participating children are used as a part of craft activities, a slide show, social media, and marketing purposes. By attending VBS, you are granting Venice Free Methodist Church permission to photograph your child for these activities.

In case of an emergency, please list someone for us to contact if we are unable to reach the listed parent/guardian.

Please list below alternate adults who are authorized to pick up your child from VBS. We check IDs (i.e. Driver's License) to ensure your child is released to the appropriate person.

First Name

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Last Name

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Address 1

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City

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ZIP/Postal Code

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Contact Phone 1

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Contact Phone 2

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Text Message Phone

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Alternate Pickup Name

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Alternate Pickup Phone

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Alternate Pickup 2 Name

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Alternate Pickup 2 Phone

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Home Church Affiliation

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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.

Tell Us About Your Participant

First Name

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Last Name

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Date Of Birth

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Grade Entering

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Gender

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Shirt Size

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Allergies

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Medical Concerns

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Is this your child's first time attending VBS at Venice FMC?

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If yes, how did you hear about VBS?

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Comments

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