VBS REGISTRATION FORM Child's InformationChild's Name* First Last Age*Last Grade Completed*Does your child have any food allergies?*NoYesPlease tell us more about your child's food allergies...Does your child have any medical conditions?*NoYesPlease tell us more about your child's medical condition...Parent/Guardian InformationName* First Last Email Address* Phone*Emergency ContactName* First Last Relationship to Child*Phone*Additional InformationWould you like to purchase a music CD for $5.00?*NoYesI consent to the use of my child’s photograph by Thalia UMC for the purpose of promoting Thalia UMC. This includes Thalia UMC publications and website.*No, I do not consentYes, I do consentCommentsThis field is for validation purposes and should be left unchanged.