VBS Registration 2018
Rolling River Rampage Vacation Bible School at Peace Lutheran Church
June 4 - 8, 2018 9AM - 12Noon Age 3 - Grade 5

VBS is an interactive, energizing, Bible-based program that gives children the chance to sing songs, create crafts, participate in mission projects, eat yummy snacks, enjoy interactive Bible stories, play fun games, and make new friends! As we Experience the Ride of a Lifetime with God, we’ll find adventure, acceptance, joy, rest, and peace on the River!

VBS costs is $10/child.

First Name of Child *
Participants First Name
Your answer
Last Name of Child *
Participants Last Name
Your answer
Child's Age *
Your answer
Child's Birth Date (DOB) *
xx/xx/xxxx
Your answer
Gender
Grade Entering in Fall *
What grade will child be in 2018-2019 school year?
T-Shirt Size *
Please note: available in CHILD and YOUTH sizes
Child's Address *
Address, City, State & Zip
Your answer
Home Phone *
xxx-xxx-xxxx
Your answer
Mother's Name *
First & Last
Your answer
Mother's Cell Phone *
xxx-xxx-xxxx
Your answer
Mother's Email *
Your answer
Mother's Address
if different than home address
Your answer
Father's Name *
First & Last
Your answer
Father's Cell Phone *
xxx-xxx-xxxx
Your answer
Father's Email *
Your answer
Father's Address
if different than home address
Your answer
Child's Physician *
Doctor's Name & Phone Number
Your answer
Child's Allergies *
Are there any food allergies this participant has? Please give details.
Your answer
Friend request (only one / must be mutual request)
Friend requests must be listed as a mutual request - your friend must also be requesting you on their registration form.
Your answer
Additional Information
Is there additional health information we need to be aware of?
Your answer
How did you hear about our VBS? *
If you have a faith community you are a part of, please list it here. *
Your answer
Can we add you to Peace Lutheran's Faith Formation email newsletter? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms