Trinity United Methodist Church

*Must be 3 years of age by September 1, 2008.
*Must register by July 1 to be guaranteed a T-shirt and to have friends placed in the same class.

*Child's Date of Birth

*Last Grade Completed
(3K - 2nd grade)

*Child's First & Last name

* Please check one: Male
Female

*Parent's First and Last name

*Street Address

*City

*Zip Code

*Daytime Phone Number

*Cell Phone Number

*Email Address

*I am a: Attend TUMC Visitor Guest of TUMC Member

If you selected Guest of TUMC Member above, please provide the member's name

Any allergies, medications, or physical limitations?

Is there someone whom this child would like to have as a classmate? (provide name)

I would like to volunteer to help with VBS: Yes
No