Contact Cahaba Heights UMC,Vestavia, AL

VBS Registration Form
Child's Name Please use a separate form for each child.
	Please select boy or girl Boy Girl
Parent or Guardian Name
Relationship to child
Address




Phone	Home
	Mobile
	Work
Child's Age Group
	Date of Birth
	Age
	Last school grade completed
Home Church
Names of People who can pick up this child from VBS
Names of People who can pick up this child from VBS


In case of emergency, contact: Parent, Guardian, Relative or Friend

Allergies or other conditions	Allergies or other conditions which may limit activity:
As parent of this child, I authorize my child to be photographed at this event, and any pictures may be used in conjunction with church related activies.	Photo Authorization Yes No
	Click to Submit Registration Form
Contact our Children's Director Jana Cook with questions.
	Church Office: 967-0470 or email janacook@yahoo.com