Vacation Bible School Registration
June 25th-29th 2018
8:45 a.m. to Noon
Shepherd of the Mountains Lutheran Church
750 Seneca Lane PO Box 3257
Jackson, WY 83001
307-733-4382
Email: sotmlcjackson@gmail.com
Registration Form-Complete One Per Child
Family Name *
Your answer
Last Name of Child *
Your answer
First Name of Child *
Your answer
Street Address *
Your answer
Mailing Address (if different)
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
email address
Your answer
Phone number (home or primary) *
Your answer
Phone number (cell)
Your answer
Phone number (work)
Your answer
Grade *
Any Food Allergies? *
If food allergies, please specify
Your answer
Emergency Contact Person *
Your answer
Emergency Contact Phone Number *
Your answer
Comments or Special Needs
Your answer
For those who are able a $15/child or $30/family pre-registration is due by June 15th and payable to Shepherd of the Mountains Lutheran Church. After June 15th cost is $20/child or $35/family registration. Pre-registration allows us to order adequate supplies! Scholarships available! Payment may be dropped off at the church in advance or brought June 25th when your child is checked in.
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