Gethsemane's Vacation Bible School 2017
June 26-June 29, 9 a.m. to noon
Please complete and submit a form for each helper or child in your family that will be attending VBS.
Household Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
ZIP Code *
Your answer
Phone Number (xxx) xxx-xxxx *
Your answer
Email Address *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Number During Event Dates (xxx)xxx-xxxx *
Your answer
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's Date of Birth (MM/DD/YYYY) *
MM
/
DD
/
YYYY
Last Grade Completed *
Permission to Photograph *
Permission to Attend *
Allergies for any children: *
Describe Allergies:
Your answer
From where did you learn of VBS? *
Do you currently have a church home *
I would like to learn more about Gethsemane Lutheran Church *
I would like to learn more about Gethsemane Lutheran School *
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