Beach Party
Surfing Through the Scriptures
VBS 2008 REGISTRATION
Deadline is July 7th !
3221 SW Burlingame Road, Topeka, KS 66611-2006
Phone - 785.266-7541  Fax - 785.266-7747
cumc@countrysideumc.org
A Place to Grow in Christian Faith and Love
Child's name:
Age:
Date of birth
Grade in Fall '08
Home Address:
Home phone number:
Parent(s) name(s)
Emergency Contact
Phone number
Name & relationship of those authorized to pick child up:
Allergies / Other pertinent info:
I will help with:
Teacher / Leader
Craft or snack supplies
Other helper
Thursday Family Night
Decorations
 Friday teacher luncheon
My child listed above has my permission to participate in physical activity at the
2008 VBS hosted at Countryside UMC. I will not hold CUMC liable for any injury that
may result while involved in activities and events during VBS 2008. My printed name
below constitutes my acceptance of this statement and is as real as my signature.
Submitted by:
E-mail address:
Phone number: