Please send us the following information for each child you would like registered by e-mail or
by regular mail at:
FUMC VBS Registration
PO Box 7
Fredericksburg, PA 17026

Child's Name: ___________________________________________

Age: _______________Grade : ____________Birth Date:___________

Complete Home Address:______________________________________________________

___________________________________________________________________________

Parent or Guardian:__________________________________________________________

Phone Number:_______________________________________________________________

Home Church:________________________________________________________________

Please list any pertinent information concerning this child (medical conditions

food allergies, etc.):________________________________________________________

____________________________________________________________________________

Doctor's name and phone number:___________________________________________