State Street UMC VBS 2018 June 18-20 Registration 5:15-5:45 VBS- 5:45-8:30 VBS 2018 Please complete one form per child. Name* First Last Age*Date of Birth*Last school grade completed*Name of Parents*Email* Enter Email Confirm Email PhoneAddress* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home ChurchList any food allergies or medical conditions* Emergency Contact InformationName of emergency contact* First Last Phone of emergency contact*Relationship to child*CAPTCHAEmailThis field is for validation purposes and should be left unchanged.
