VBS Registration %% - Faith Lutheran Church & Preschool

Vacation Bible School | July 31 to Aug 4, 2017 | 9am-12pm

Child's Name
First Last
Gender
- Male
- Female
Grade ENTERING fall 2017*
Age of Child
Date of Birth*
Allergies or other medical conditions
Mother's Name
First Last
Father's Name
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Emergency Contact*
First Last
Emergency Contact Phone
I understant my child 1) must wear tennis shoes EVERY DAY, 2) May get a little messy, and 3) will probably get wet*
- Yes, I understand
Please type your name in the space below indicating the above information is correct.