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Gethsemane's Vacation Bible School 2018
June 25-June 28, 9 a.m. to noon
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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
*
None (Preschool)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
Helper
Permission to Photograph
*
Allow
Don't Allow
Permission to Attend
*
Allow
Don't Allow
Allergies for any children:
*
Yes (Describe Below)
No
Describe Allergies:
Your answer
From where did you learn of VBS?
*
church announcements
church signs along Old Maple & 108th Street
friend
flyer
registration form in member mailbox
Do you currently have a church home
*
Yes
No
I would like to learn more about Gethsemane Lutheran Church
*
Yes
No
I would like to learn more about Gethsemane Lutheran School
*
Yes
No
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