Cave Quest Registration - June 19-23 3-6pm
Please complete this form for VBS Registration; 50 spots are available for children age 5-12.
Child's Name
Your answer
Parent/Guardian Name
Your answer
Parent/Guardian email address:
Your answer
Child's Birth Date
MM
/
DD
/
YYYY
Child's T-shirt Size (youth size)
Required
Child's Age (as of June 1, 2017)
Your answer
Street Address
Your answer
City, HI, Zip Code
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone Number
Your answer
Allergies or Other Medical Conditions
Required
Name of Home Church, If any
Your answer
Photograph Release: Please select below regarding photography during VBS.
Required
Parent/Guardian eSignature: By typing your name below and submitting this form you give your child permission to participate in Cave Quest activities at Kihei Lutheran Church, June 19-23.
Your answer
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