Who Is My Neighbor? VBS Registration
Date: July 21 - 25, 2019
Dinner: 5:15-6:00 pm
VBS: 6:00-8:00 pm
Place: Mt. Hermon Lutheran Church Fellowship Hall
Use the Methodist Park Rd entrance.
Contact us at (803) 794-6430 or office@mthlc.org
Child 1's Name
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Child 1's Age
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Child 1's Date of Birth
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Child 1's Grade Completed
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Child 1's Special Needs/Food Allergies
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Child 2's Name
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Child 2's Age
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Child 2's Date of Birth
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Child 2's Grade Completed
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Child 2's Special Needs/Food Allergies
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Child 3's Name
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Child 3's Age
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Child 3's Date of Birth
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DD
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YYYY
Child 3's Grade Completed
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Child 3's Special Needs/Food Allergies
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Parent/Guardian Name
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Parent/Guardian Cell Number:
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Parent/Guardian Home Number:
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Emergency Contact Name (other than parent)
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Emergency Contact Phone Number
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Emergency Contact Relationship
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List Of Who May Pick Up Your Child(ren)
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