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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