Upland United Methodist Church
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Upland UMC
2016 Child Registration
Enter your child's information below in advance of the next Family VBX, July 17 at 6 PM.
Click here to RSVP and follow event on Facebook.
Name
*
First
Last
Birthdate (MM/DD/YYYY)
*
Home Church
*
Select One
*
Male
Female
Grade (for 2016-17)
*
Pre-K
K
1
2
3
4
5
6
7
8
Environment
*
Camp Walk-Along (Downstairs; nursery thru Kindergarten)
Squeezed (Upstairs; 1st Grade thru 8th Grade + Families!)
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Parent/Guardian
*
First
Last
Parent/Guardian Email
*
Parent/Guardian Phone
*
Additional Emergency Contact
*
First
Last
Emergency Contact Phone
*
MEDIA RELEASE:
I grant to Upland United Methodist Church and its children’s ministry, employees, and volunteers the right to take photographs, video, and/or electronic images of any member of my family in the children’s ministry environment. I authorize Upland United Methodist Church and its children’s ministry to copyright, use, and publish the photographs, video, and/or electronic images in print and/or electronically—with or without our names—for any lawful purpose to highlight and promote Upland United Methodist Church and its children’s ministry.
I agree to the above Media Release statement.
*
Yes
No
If applicable, please describe any medical conditions, allergies, custody restrictions, or other important information of which we should be aware. This information will be kept confidential.
*
Submit
