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2016 VBS: INTO THE LIGHT
***HURRY! Registration closes 30 Nov 2016 or when maximum participants reached, whichever is sooner.
" Your word is a lamp for my feet, a light on my path " - Psalm 119:105
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CHILD'S DETAILS
Name of Child (Full Name)
*
in capital letters, name per registry if applicable ( eg : LILY TAN LI LI)
Your answer
Gender
*
F
M
Birthdate
*
- child must be born between 2003-2010, age 6-13 ONLY
MM
/
DD
/
YYYY
Age
*
6
7
8
9
10
11
12
13
Day (D) or Stay In (S) program?*
*
*Only those aged 9 and above allowed to stay in
D
S
T Shirt Size
*
Please measure the child's existing t-shirt under the arms (in inches). For registration AFTER early bird deadline, T-shirt sizes subject to availability
28
30
32
34
36
38
40
42
Church child attends (if any)
*
Please provide us with the name of the church if applicable ( eg : KLANG WESLEY). State 'None' if the Child does not currently attend any church or sunday school program
Your answer
Any medical allergies / special needs
*
Help us understand if your Child require special meals or need to avoid certain food (eg :NUTS, DAIRY ETC). Otherwise, state "None"
Your answer
Home Address
*
Your answer
PARENT'S DETAILS & EMERGENCY CONTACT INFORMATION
Parent's name
*
Name of Child's Parent/Guardian whom we can easily reach
Your answer
Parent's Contact Number
*
provide us with a number that child's Parent / Guardian can be reached ( eg : 012-XXX XXXX)
Your answer
Parent's email address
*
will be used to send updates on program only ( eg :
john@gmail.com
)
Your answer
Emergency contact (if different from parent's details)
Tell us whom to get in touch with if the need arises ( eg :John / 012-444 1234)
Your answer
PAYMENT DETAILS
Bank transfer to "WESLEY METHODIST CHURCH KLANG" UOB 1713155611. Please email a copy of your bank transfer receipt to
wesleyklangss@gmail.com
. Before you hit submit, kindly share with us the Transaction details from your Bank.
Amount Paid (MYR)
*
Please refer to schedule of fees
Your answer
Bank Name
*
Your answer
Transaction/Receipt number of Bank Transfer
*
Please insert your payment reference/transfer number. This will be an auto generated number from your bank
Your answer
INFORMATION & FEE SCHEDULE
ACKNOWLEDGEMENT& PARENTAL CONSENT
ACKNOWLEDGEMENT : I hereby grant permission for my child to attend VBS at Wesley Methodist Church Klang. I understand that whilst every reasonable care will be taken, I will not hold the church and her staff / helpers responsible for any mishap. I allow the organizers to take the appropriate medical attention in the event of an emergency.
*
I Agree
Required
PARENTAL CONSENT : As this is an electronic form, No signature is required. However, by completing and submitting this form, you are deemed to have acknowledged the contents and given your consent for your Child to be enrolled.
*
I Agree
Required
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