Lutheran Church GOD ROCKS! VBS Registration
Please fill out this registration form to be a part of Lutheran Church's GOD ROCKS! VBS on June 24-27, 2013! Registration fee for the week is $10. (Please note - THIS IS A SAMPLE FORM.)
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Name of Parent or Guardian *
Address *
City, State, Zip *
Phone Number *
Work/Cell Phone
Email
Emergency Numbers (2) *
Please include name, how the person is related to the child(ren), and a contact number.
Participant Registration
You may enter up to 4 children here.  Please register each child individually.  If you're registering more than 4 children you will need to go through the form/process again.
Name of Child 1
First Last
Grade entering next fall.
Children older than 4th grade can register as volunteer helpers.
Clear selection
Special Needs/ Allergies
Are there any special needs or allergies we should be aware of for this child?
Name of Child 2
First Last
Grade entering next fall.
Children older than 4th grade can register as volunteer helpers.
Clear selection
Special Needs/ Allergies
Are there any special needs or allergies we should be aware of for this child?
Name of Child 3
First Last
Grade entering next fall.
Children older than 4th grade can register as volunteer helpers.
Clear selection
Special Needs/ Allergies
Are there any special needs or allergies we should be aware of for this child?
Name of Child 4
First Last
Grade entering next fall.
Children older than 4th grade can register as volunteer helpers.
Clear selection
Special Needs/ Allergies
Are there any special needs or allergies we should be aware of for this child?
Submit
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