Register Below!

VBS 2021 Is on the Horizon! 
August 8-12
5:30pm-7:30pm

Registration fee is $40 per camper for the week.

Please mail or bring payment (cash or check) to:
Salem United Methodist Church
350 Manor Road
Wexford, PA 15090

If you wish to pay online, please visit our “DONATE” button at the bottom of our home page to pay via PayPal.  Once on the PayPal site, PLEASE WRITE A NOTE that your payment is for VBS by clicking on “Add special instructions to the seller“.

Please complete a separate registration form for each camper that you are enrolling.

Salem Vacation Bible School 2021 Registration
Parent / Guardian Name *
First
Last
Parent / Guardian Email *
Parent / Guardian Contact Phone Number *
Parent / Guardian Mailing Address  *
Number
Parent / Guardian Mailing Address *
Street
Parent / Guardian Mailing Address *
City
Parent / Guardian Mailing Address *
Zip Code
Camper's Name *
First
Last
Camper's Age (as of August 8, 2021) *
Camper's Last Grade Completed (as of August 8, 2021) *
Allergies, Special Needs, or Medical Conditions
Additional Emergency Contact Name (In case parent / guardian cannot be reached) *
Additional Emergency Contact Phone (In case parent / guardian cannot be reached) *
I give permission for my child to have their photograph, video, or sound recording published on Salem United Methodist Church's Website
Parent Name
Submit