VBS Registration (WAIT LIST)
St. Andrew Lutheran Church
5607 NE Gher Rd. Vancouver, WA 98662
360-892-7160

Use this form to register up to five children for Vacation Bible School. A printed form will be available for your signature when you arrive at VBS. Vacation Bible School is open to ages 4 through 5th grade in the fall.

Registration is full; this form is for the VBS Wait List.

Parent information
Email
Your answer
Last name
Your answer
First name
Your answer
Address
Your answer
City State ZIP
Your answer
Cell phone
Your answer
Phone 2
Your answer
Home church
Your answer
I agree to allow photos to be used in church presentations or promotional materials
Person responsible for pickup, if different
Your answer
Pickup person phone and comments
Your answer
Emergency contact and phone
Your answer
Medical information
Please provide medical insurance company, address, insured's name, policy#, group# and ID#. Physician's/Group's name, hospital preference and location.
Insurance
Your answer
Physician
Your answer
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