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2019 Vacation Bible Camp
*If your child is not able to attend Bible Camp once you've registered, please notify us as soon as possible. Thank you for this courtesy! Please remember that registration is on a first-come, first-serve basis. If your child's grade level is full, you will be added to a wait list and we will contact you later with more information.*
Miraculous Mission - Jesus Saves the World!
Bethlehem Lutheran Church, 9748 Copeland Drive, Manassas, VA 20109
Child's Name: *
Your answer
Last Grade Completed (choose one) *
Date of Birth: *
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Child's Age: *
Your answer
T-shirt Size (choose one) *
Parent Name: *
Your answer
Home Address: *
Your answer
Home Phone: *
Your answer
Cell Phone: *
Your answer
Email Address: *
Your answer
Emergency Contact Person: *
Your answer
Relationship to Child: *
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Home Phone: *
Your answer
Alternate Phone: *
Your answer
List of people who may pick up your child: *
Your answer
Food Allergies? *
If yes to Food Allergies, please list: *
Your answer
Medical Concerns? *
If yes to Medical Concerns, please explain: *
Your answer
Digital Images - Pictures and video recordings may be taken of your child during Bible Camp activities. Some of these images will be used in a slideshow presentation for our final day of camp on Friday, August 9. Children's names will NOT be included in this presentation. *
Family Night - Will you and your family be joining us for Family Night on Friday, August 9 at 6:30 pm? *
If yes to Family Night, please list the number of adults and children attending: *
Your answer
How did you hear about our Bible Camp? *
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