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St. Marks United Methodist Church
A light dinner will be offered each evening between 5:30 and 6:00 for family members and VBC attendees , and 
Camp will begin at 6:00 for children between ages 3 and 13.  Each nightly session will conclude around 8:00.

Please sign-up using the form below and please complete all fields.
                                                                                       mm/dd/yy       Completed   Peanut        Milk           See Notes
First Name                Last Name            Sex (M/F)     Date of Birth       Grade        Allergy?   Allergy?   (sectionbelow) 
                                                                                                                                                                                                                                                                     Post Pictures on
Relationship         First Name            Last Name                            Cell Phone              Land Line              e-mail  Address                    Church Attending             social media ???
Please provide the following Parent / Guardian / Emergency Contact information
Please indicate anything we should know about your children's health, allergies, etc.  Start notes by specifying Child's Name.
Child 1

Child 2

Child 3

In addition to the adult persons identified above, the following individuals may pickup my children each evening at the end of the session. 

Please enter the resident address for the identified campers.  If any of the identified campers live at a different address, please use a separate form for registration.