Community Bible School

June 17,18,19 5:00-8:00 PM

Waynesville Middle School

sponsored by First United Methodist Church

On line Registration Form

Child's Name   Age

street address

city, statezip code

Home PhoneCell Phone

E-Mail Address

Date of Birth  Last Grade Completed

Emergency Contact

Phone

Mother's Name    Father's Name

Allergies or other special information

Home Church

How did you hear about Starlight Rescue Community Bible School?

Dinner Reservation:  We will offer dinner at no cost to you each eveing of Bible

School serving from 5:00-5:30 PM.  We will serve a light, child-friendly meal.

Reservations are necessary.

Please include us in the count for dinner.

Tuesday, June 17     Adults:                 Children:

                Wednesday, June 18     Adults:                  Children:

                    Thursday, June 19     Adults:                  Children:

              No, We do not wish to join you for dinner but will bring our children in

to the Mission Control station each evening by 5:55.

Photo Release Form - We take lots of pictures to be used on our website and to

give each child as a remembrance of the event.  Our policy is that we do not use

any whole names of children, only first names, to identify pictures.  We only use

pictures of children for whom we have this consent form.

I hereby give my consent for First United Methodist Church to use my photograph

and likeness to be used in its publications, including this website.  I release them

from any expectation of confidentiality for the undersigned minor children and

myself and attest that I am the parent or legal guardian of the children listed on

this registration form.

yes

No

Agreement