Relationship to Child

Home Address

WE HOPE TO SEE YOU THIS YEAR!

Medical Concerns

Alternate Phone Number

Child's Name *

Home Phone

Transportation Needed?

Birthday *

List any siblings attending VBS

List Names of Those Who May Pick Up Child

Church Affiliation?

Grade Completed *

Emergency Contact Person

Age of Child

Parents Namess

Family Doctor

Any Food Alergies

Contact Email: *

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Lewistown-Trinity UMC

Vacation Bible School

Watch Here for Upcoming Information

Our VBS is for Children

Ages 4 through 5th grade

If you have any questions regarding VBS,

please call (937) 686-8755

You May Enter Your Child ONLINE (see below)

If you have more than one child attending, please submit one child's information per form.