Foothills 2023 One-Day VBS Registration

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Child 1 - Information

* So that children have the best possible experience at Vacation Bible School, they must be able to understand and speak English in order to attend.

First Name (child 1) *

Last Name (child 1) *

Date of Birth (child 1) *

YYYY

Last Grade Completed (child 1) (June 2023) *

Allergies/medical concerns (child 1) *

Child 2 - Information

(Optional)

First name (child 2)

Last name (child 2)

Date of Birth (child 2)

YYYY

Last Grade Completed (child 2) (June 2023)

Allergies/Medical Concerns (child 2)

Child 3 - Information

(Optional)

First name (child 3)

Last name (child 3)

Date of Birth (child 3)

YYYY

Last Grade Completed (child 3) (June 2023)

Allergies/Medical Concerns (child 3)

Child 4 - Information

(Optional)

First Name (child 4)

Last name (child 4)

Date of Birth (child 4)

YYYY

Last Grade Completed (child 4) (June 2023)

Allergies/Medical Concerns (child 4)

Parent Names

Names *

Home Address *

Postal Code *

Home Phone Number *

Cell Phone Number *

E-mail Address *

Alternate Contact (Name and Telephone Number) *

Home Church

A member of my family is interested in volunteering

Yes

Other:

I acknowledge that I must fill out, sign and return the waiver and permission form to Foothills Lutheran Church in order for registration to be complete. https://docs.google.com/document/d/1gAsa_lISf8RDzEAUp7fSN3NoEgW9TPKz/edit?usp=sharing&ouid=113200871062507032028&rtpof=true&sd=true

Required

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