Living Hope Bible Church Vacation Bible School 2017 Registration
Date: July 17 - 21, 2017,
9am-12pm
Closing Ceremony: July 21, 2017, 7pm-8:15pm
Location: 205 Mountain Park Blvd. SW, Issaquah, WA 98027
Contact us at (425) 587-1232 or vbs@livinghopebible.org


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Child First Name
Your answer
Child Last Name
Your answer
Child Gender
Required
Birth Date
MM
/
DD
/
YYYY
Age (on July 17, 2017)
Required
School Grade Just Completed in 2016-2017 School Year
Required
Address (Street Number, Street, City, Zip Code)
Your answer
Cell Phone (to reach you during VBS if necessary)
Your answer
Email
Your answer
Parent(s)/Legal Guardian(s) Name(s)
Your answer
Emergency Contact (Cell Number and Name)
Your answer
If anyone is authorized to pick up your child other than yourself, please list them here, along with their relationship to the child.
Your answer
Allergies or Other Medical Conditions (Please only list food that causes an allergic reaction to your child. We will do our best to provide healthy snacks that meet all allergenic needs. However, if your child has multiple food allergies, you may want to pack a daily personal snack.)
Required
Name of Home Church, if any
How often does the student attend church?
How did you hear about our VBS? Check all that apply.
If invited by a friend, who?
Your answer
Would you like your student to be placed in the same group as their sibling or friend? (if ages are similar)
Special Instructions/Requests
Your answer
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