VBS Registration - BETHEL MINISTRIES of FORT WAYNE

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VBS Registration

Household Contact Information

* Indicates required field

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Home Phone *

Parent/Guardian Cell Phone *

Address *

Line 1

Line 2

City

State

Zip Code

Country

2nd Parent/Guardian Name *

First

Last

2nd Parent/Guardian Email *

2nd Parent/Guardian Home Phone (if different) *

2nd Parent/Guardian Cell Phone *

Emergency Contact (include name and number) *

Please provide an emergency phone number or email address.

Who Else Can Pick Up The Child/Children? *

How did you hear about VBS at Bethel UMC? *

Child's Name (1st Child) *

First

Last

Gender *

Male Female

T-Shirt Size *

Birthdate *

Last School Grade Completed *

Allergies *

Home Church *

Additional Information *

Child's Name (2nd Child) *

First

Last

Gender *

Male Female

T-Shirt Size *

Birthdate *

Last School Grade Completed *

Allergies *

Home Church *

Additional Information *

Child's Name (3rd Child) *

First

Last

Gender *

Male Female

T-Shirt Size *

Birthdate *

Last School Grade Completed *

Allergies *

Home Church *

Additional Information *

Child's Name (4th Child) *

First

Last

Gender *

Male Female

T-Shirt Size *

Birthdate *

Last School Grade Completed *

Allergies *

Home Church *

Additional Information *

Child's Name (5th Child) *

First

Last

Gender *

Male Female

T-Shirt Size *

Birthdate *

Last School Grade Completed *

Allergies *

Home Church *

Additional Information *

Register

We Would Love to Have You Visit Soon!

Address:
8405 Lima Road
Fort Wayne, IN 46818

Office Hours:
M/W/FR 9am - Noon

Church Office Phone:
260-489-3651

Office e-mail:

bethelchurch@my

Worship Schedule:
Sundays @ 11am

Home
Location and Service Info
Meet the Pastor
Pastor's Reflection
Meet Our Staff
History of Bethel
Sunday School
Small Groups
Birthdays, Anniversaries & Shut-ins
Childcare
Bethel Women
Travelers