Living Word VBS Sign Up 2017
Imagine a world where curious kids become hands-on inventors who discover they're lovingly crafted by God. Join us for a week of fun from 9am-12pm each day of the week! VBS runs from August 7 - 11th
Email address
Child's First Name
Your answer
Child's Last Name
Your answer
Birthdate
MM
/
DD
/
YYYY
Age
Your answer
Grade entering in the fall
Mother's Name
Your answer
Mother's Cell Phone Number
Your answer
Father's Name
Your answer
Father's Cell Phone Number
Your answer
Full home mailing address
Your answer
Home Church
Your answer
Food or other Allergies
If yes, explain (please bring epi pen if required)
Your answer
Other medical condition
If yes, explain
Your answer
Emergency Contact (other than parent)
Your answer
Emergency Contact phone number
Your answer
Relationship to child
Your answer
People other than parent authorized to pick up child
Your answer
I do hereby give Living Word Lutheran Church permission to publish the picture of my child
How did you hear about Living Word VBS?
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