Vacation Bible School, 2024 Registration Please enable JavaScript in your browser to complete this form. St. Luke's United Methodist Church 206 Scheurmann, Essexville, MI Wednesday, July 17 & Thursday, July 18, 2024 5:00 pm to 8:00 pm (Light dinner will be served for children and families @5PM) For Pre-school through 5th grade Registration deadline July 10, 2024 Child's Name *FirstLastChild's Age *Child's Birthday *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Last School Grade complete *Kindergarten, 1st, 2nd, 3rd, etc.Parent's Name *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeParent's EmailEmailConfirm EmailHome Phone *Cell PhonePreferred method of contactPhone callEmailPlease indicate how you would like to be contacted in case of questions.Home ChurchAllergies or other medical conditionsEmergency Contact Name *Emergency Contact Phone *Relationship to Child *Parent, grandparent, caregiver, etc.Photo Release for this eventYes, it's ok to use photos of my child.No, please do not use photos of my child.I am not the legal parent or guardianI, the legal parent or legal guardian, of this child, grant St. Luke's United Methodist Church, my permission to use the photographs taken at this event, for any legal use, including but not limited to publicity, illustration, and web content. Questions/Notes/CommentsAny questions or comments you would like to add? Submit