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Fun Maker Factory Vacation Bible School Registration
St. Trinity Lutheran Church
7404 Vermont Ave.
Monday - Thursday, July 17th - 20th
5:30 (dinner) - 8:00 PM
Email address
Kid's Age 3 (Bathroom Independent) - Finished 5th Grade
Child Name and Age
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Child Date if Birth
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DD
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YYYY
Child Last Grade Completed
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Child's Gender
Parent(s) /Guardian(s) Name
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Street Address
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City
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State
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ZIP
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Parent/Care Giver Cell Phone or Best Phone #
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Home Church (if you have one)
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Allergies or Medical Conditions We Need to Know About
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In Case of Emergency, Contact (additional to above)
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Phone #
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Relationship to Child
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I give permission for photos and images of my child to be used in online and printed pieces (ie: Facebook, website, videos). Last names will not be used.
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