Batavia United Methodist Church Vacation Bible School Registration

When

: July 27 - 31, 9am – noon

Who

: Children age four (as of 9/1/09) through rising fifth graders (Children must bepotty-trained)

Cost

: $20 per child;Three or more per family:$50 totalREGISTRATION DEADLINE IS

July 12

.FORMS RECEIVED AFTER July 12 WILL INCURE A $5 LATE FEE.REGISTRATION IS NOT COMPLETE UNTIL SIGNED FORM AND FEE IS SUBMITTED.Child’s Name: ____________________________________________ Age: ____________ Date of Birth: ____________________________________ Grade for fall ’09: _____________ Street Address: ________________________________ City: ___________________________ Parent/Guardian: _______________________________________________________________ Home phone: _______________________Work/Cell phone: ___________________________ Emergency Contact(s): (other than parents/guardian)Name: ___________________________ Phone: _____________________ Name: ___________________________ Phone: _____________________ Physician: _______________________ Phone: _____________________ Allergies/Physical/Dietary Concerns: _______________________________________________ To further enhance this family approach, we are encouraging parents/guardians to join theirchild(ren)’s tribe during the week. Please indicate which days you plan to visit Camp Edge: _____ Monday _____ Wednesday _____ Friday _____ Tuesday _____ ThursdayChild’s Home Church: _________________________________ (Over please!)