Rolling River Rampage Registration
Zwingli UCC and Little Zion Lutheran Church Vacation Bible Camp Registration
www.zwingli.org 215.723.1186 office@zwingli.org 350 Wile Avenue, Souderton PA

Please fill out one form per child.
This program is designed for children pre-school age through entering fifth grade. Children must be toilet-trained. For more information visit Zwingli.org or LittleZion.org.
Child's First Name
Your answer
Child's Last Name
Your answer
Grade Entering in Fall
Your answer
Allergies
Your answer
Please share any special accommodations that your child may need.
Your answer
Our VBC program is volunteer-run.
We will do our best to meet accommodations; we cannot make any promises. If we cannot meet these needs, we will invite you to join your child as they go through this year's VBC program. Thank you for understanding.
Parents' Names
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Work Phone
Your answer
E-mail Address
Your answer
Who will be picking up your child?
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone Number
Your answer
PHOTO CONSENT FORM
If you've not yet done so, please review our photo release document at zwingli.org/vbc.php. You can either print it and bring a signed copy with you, or we will have copies available for you to sign on the first day of VBC.
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