Tanner Valley United Methodist Church
Friday, November 17, 2017

VBS Registration

Tanner Valley logo
 
Completing this form will speed up your check-in process (particularly the first night).  You will still need to sign the release, but the information will already be completed for you based on the information you provide here.

 
Parent or Guardian's Info
Last Name    
First Name   
Address        
City      ST       Zip      
Mobile Phone Number  
Home/Other Phone Number    
Email Address                 
Do you regularly attend any local church?
No  Yes:
             Tanner Valley   Other: 
 
How did you hear about our VBS? 
School Newsletter    Daycare    Other:  
 
Emergency Contact:  Phone: 
If you are not available to pick up your children: list two adults who may pick them up. (Photo ID will be required.)
1.       2. 
 
May we take photos of your child(ren)?     Yes    No
May we use photos of your child(ren) for our church publications?     Yes    No

 
Child(ren) Information
Child 1
Last     
First     
Gender:  Male    Female      Age: 
Grade he/she will enter next school year:
     Preschool       K       1st       2nd       3rd       4th       5th
Special Notes/Allergies:
 
 
Child 2
Last     
First     
Gender:  Male    Female       Age: 
Grade he/she will enter next school year:
     Preschool       K       1st       2nd       3rd       4th       5th
Special Notes/Allergies:
 
Child 3
Last     
First     
Gender:  Male    Female      Age: 
Grade he/she will enter next school year:
     Preschool       K       1st       2nd       3rd       4th       5th
Special Notes/Allergies:
 
Child 4
Last     
First     
Gender:  Male    Female      Age: 
Grade he/she will enter next school year:
     Preschool       K       1st       2nd       3rd       4th       5th
Special Notes/Allergies:
 

By submitting this form, I acknowledge that I have read and understand the following: 
  1. I will be expected to sign this release the first night my child attends Tanner Valley's VBS.
  2. I understand that Tanner Valley UMC will not share my information with any outside group.
  3. I understand that my information submitted will be used only for registration purposes, child safety and perhaps future contact from Tanner Valley.
  4. In case of accident or sickness, I understand every effort will be made to contact the parent if emergency treatment is needed.  In the event contact cannot be made, the following statement authorizes such treatment as may be requiredI the Parent or Guardian of the above named minor(s), do hereby authorize the representative of Tanner Valley UMC as agent to give specific consent to any diagnosis, treatment, or hospital care which a duly licensed physician or surgeon may deem necessary.
 
NOTE:  A shuttle may be available for pick up near Central Elementary for those with transportation issues from downtown Lawrenceburg. 
Space is limited and separate registration is required (contact 537-2170 to make arrangements).