Eldridge United Methodist Church
Please fill out all the required fields below to register your child(ren) for vacation bible school at Eldridge United Methodist Church. Please use "NA" in fields that will be left blank. Please complete the Captcha below & hit the send button and wait for the confirmation message. If you have any questions or would prefer to register over the phone, please call the church office at 563-285-4314.
1.) Child's Name (required)
Child's Grade in the Fall (required)
—Please choose an option—N/A4-5 yrs oldK1st2nd3rd4th5th6th
Child's birthdate: (required)
2.) Child's Name (required)
3.) Child's Name (required)
Parent's Name (required)
Email Address (If using an @yahoo.com or @aol.com email, please call to register. (required)
Phone Number (required)
Mobile Phone Number
Texting Available?
YesNo
Your Street address
City
Your home church
Food or medical allergies (if any)
Emergency Contact name (required)
Emergency Contact Phone (required)
Emergency Contact Relationship (required)
Person(s) who may pickup child:
1.)Name of person that may pickup child (required)
Contact Phone (required)
2.)Name of person that may pickup child (required)
Photography permissions:
I am giving permission to take photos of my child(ren) during the VBS activities:
I am giving permission to use photos of my child(ren) for promotion of VBS on EUMC's website & Facebook page:
Any additional information you would like to provide