Ascension VBS-DayCamp Registration 2017
Please fill out this form completely and then mail your total registration fee to Ascension Lutheran Church, 2901 Libal Street, Green Bay, WI 54301.

$30 per Jr. VBS child (3-yr-old through entering 1st grade in the fall)
$40 per DayCamper (entering 2nd-7th grade in the fall)
$30 per Jr. VBS Plus child (1st grade or younger child with older sibling in the Crossways program)
MAX PER FAMILY: $90 for all
***Scholarships available - talk to Cindy!

Family Information
Parent Name(s) *
Your answer
Parent Email(s) *
Please specify name for each email provided. Include all the email address to which you'd like us to send info (for example, home and work).
Your answer
Address *
Please include street, city, state, and zip.
Your answer
Phone Number(s) *
Please specify names and home/work/cell for all numbers!
Your answer
Phone number where parent can be reached DURING DayCamp times *
Your answer
Emergency Contact Name and Number *
(in case parents can not be reached during DayCamp)
Your answer
What is the name of your home church? *
Child 1 Information
First and Last Name *
Your answer
Child's Birthdate *
What grade will your child be in the fall? *
T-Shirt Size? *
Are there any concerns you'd like to share with us? (Allergies, physical, dietary, behavior, or other concerns)
Your answer
If this child is going into 1st grade or younger AND has siblings in the Crossways full-day program, would you like for this child to stay for the afternoons? *
NOTE: if you choose YES to say you want this child to stay into the afternoon with his/her older Crossways sibling, this will increase your cost for this child to $40 for the week (same price as a Crossways camper)
Do you have other children to add? *
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