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Wilderness Escape VBS Participant Registration St. Paul Lutheran
July 7th-11th, 9:00am-11:30am. Open to 3 year olds through 6th grade.
This event is sponsored by Thrivent Financial for Lutherans.
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* Indicates required question
Parent/Guardian Full Name(s)
*
Your answer
Child's Full Name
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Your answer
Child's Gender
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Male
Female
Grade Entering:
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3 Year Old
4K/ 4 Year Old
5K
1st
2nd
3rd
4th
5th
6th
Child's Age
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Your answer
Would you like to purchase a CD of the Wilderness Escape VBS music?
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The cost per CD is $6.00. Checks can be made out to St. Paul Lutheran Church.
Yes
No
Would you like to purchase a Wilderness Escape t-shirt for your child?
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The cost per t-shirt is $6.00. Checks can be made out to St. Paul Lutheran Church.
Yes
No
T-Shirt Size (If purchasing)
Choose
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
No Shirt
Child's Address
*
Your answer
Contact Phone Number #1
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Your answer
Contact Phone Number #2
Your answer
Parent Email Address
Your answer
City
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Your answer
State
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Your answer
Zipcode
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Your answer
Does your child have any allergies we should be aware of?
Your answer
Does your child have any medical concerns we should be aware of?
Your answer
Are you a Thrivent Financial member? (This is for informational purposes only.)
*
Yes
No
Option 3
Emergency Contact Name
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Your answer
Emergency Contact Phone Number
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Your answer
Emergency Contact Relationship
Your answer
Alternative Pick-Up Phone
Your answer
Alternative Pick-Up Name
Your answer
Alternative Pick-Up Phone 2
Your answer
Alternative Pick-Up Name 2
Your answer
Do you have any additional comments?
Your answer
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