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VBS 2018 Shipwrecked
Age 3 through 5th Grade
June 11th-14th
9:00a.m. to 11:30 a.m.
Cost per child is $5 before May 21st, after May 21st it is $8
Child's Name Attending-Please list first and last name *
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Child's Age *
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2nd Child's Name-Please list first and last name
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Child's Age
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3rd Child's Name-Please list first and last name
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Child's Age
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4th Child's Name-Please list first and last name
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Child's Age
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Parent Name-Please list first and last name *
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Street Address *
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City *
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Zip *
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Home Phone *
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Cell Phone *
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Email Address *
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Additional Contact Person in case of emergency-name and phone *
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Allergies or Medical Conditions *
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Would you like to be contacted to help with VBS? *
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By checking the box below the parent or guardian of the above named youth hereby grants permission for the use of VBS participant's image in Trinity's and synodical publications or in newspapers as long as the participant's name or address are not published. *
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