Feliciana Methodist Church
July 11, 2026
8:30 a.m.-12:30 p.m.
Jackson Hall
at Grace Episcopal Church

For Students 3 years old through 5th grade

Question Title

* Please provide the following information about the child/children you are registering for VBS:

Child 1-First Name

Child 1-Last Name

Child 1-Date of Birth (MM/DD/YYYY)

Child 1-T-shirt size

Child 2-First Name

Child 2-Last Name

Child 2-Date of Birth (MM/DD/YYYY)

Child 2 T-shirt size

Child 3-First Name

Child 3-Last Name

Child 3-Date of Birth (MM/DD/YYYY)

Child 3 T-shirt size

Child 4-First Name

Child 4-Last Name

Child 4-Date of Birth (MM/DD/YYYY)

Child 4 T-shirt size

Question Title

* If you need to register more than 4 children, please type their first and last names and dates of birth below.

Question Title

* Information about the person registering the children for VBS.

First Name

Last Name

Phone Number

Question Title

* Please provide two people we can contact in case of an emergency and their phon numbers.

Emergency contact #1 and phone number

Emergency contact #2 and phone number

Question Title

* Special needs/allergies/medical information/other information we need to know about the children registered on this form.

Question Title

* Name(s) of person(s) who may pick up child/children from VBS

Question Title

* By typing your name in the box below, you are giving Feliciana Methodist Church permission to use your child's/children's photograph publicly in VBS materials. You are also acknowledging that the images may be used in print publications, online publications, presentations, on the church website and in social media publicity about VBS. In addition, you are acknowledging that no royalty, fee or other compensation shall become payable to you by reason of image use.

Digital signature

Date

Feliciana Methodist ChurchJuly 11, 20268:30 a.m.-12:30 p.m.Jackson Hall at Grace Episcopal Church

For Students 3 years old through 5th grade

Question Title

* Please provide the following information about the child/children you are registering for VBS:

Question Title

* If you need to register more than 4 children, please type their first and last names and dates of birth below.

Question Title

* Information about the person registering the children for VBS.

Question Title

* Please provide two people we can contact in case of an emergency and their phon numbers.

Question Title

* Special needs/allergies/medical information/other information we need to know about the children registered on this form.

Question Title

* Name(s) of person(s) who may pick up child/children from VBS

Question Title

Feliciana Methodist Church
July 11, 2026
8:30 a.m.-12:30 p.m.
Jackson Hall
at Grace Episcopal Church