register

To help us make sure we have enough staff to minister to all of our wonderful students, and to make sure we have the information we need to keep them safe, please fill out the form below for each activity you want them to be a part of. From time to time, the data we need may change, so we may ask you to submit an updated form for our records. This information will only be used within the church for official purposes.

Select Activity / Activities:

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activities. Scroll down to enter information

Family / Parent Name:

Address:

City, State ,

Home Phone: Mobile Phone:

Other Phone during the time of this activity:

Email Address:

Student 1 Name Age Grade next fall

Allergies or Medical Conditions:

Student 2 Name Age Grade next fall

Allergies or Medical Conditions:

Student 3 Name Age Grade next fall

Allergies or Medical Conditions:

Other Students -List Names & Ages Here:

What interests your child(ren):

Other Person(s) authorized to drop-off and pick up child(ren):

Emergency Contact Phone

Physician’s Name Phone

Home Church (if any)

Permission to display photos:

Pictures of the children will be taken during the week and displayed through various means and used at Cedar Grove functions and on the website.

Click here if you give permission for photos of your child(ren) to be displayed without names.

Click here if you give permission for us to include your child's first and last name in a photograph.

Please click here if you do not want your child's photograph to be displayed.

I understand that Cedar Grove United Methodist Church and the children's ministry staff will take every precaution to ensure the safety of the VBS participants and are not responsible in the event of an accident.

Please type your full name to indicate your agreement with above information: