Splash Canyon VBS Registration 2018
Event Timing: Monday, June 18 - Friday, June 22 9:00 am to 12:00 pm (noon)
Event Address: Zion Lutheran Church 6121 East Lovers Lane, Dallas, Texas 75214
Please fill out one form for each child you wish to register.
Our youngest student participants are Preschool Children who have turned 3 by 6/1/2018 and are potty trained.
Our oldest student participants are currently completing 5th grade.
Students currently completing 6th grade (and older) may volunteer as helpers.
Contact us at (214) 363-1639 or chobbs@ziondallas.org
Name *
Your answer
Gender
Birthdate *
MM
/
DD
/
YYYY
Grade Entering *
To Reserve a VBS T-shirt ($6 donation suggested), please select size. *
Allergies
Your answer
Other Medical Concerns
Your answer
One friend you would like to be placed in a group with (we cannot guarantee placement, but work to honor all reciprocal requests)
Your answer
Parent Information
Parent(s) Name(s) *
Your answer
Parent(s) Email Address(es) *
Your answer
Mailing Address *
Your answer
Parent(s) Phone Number(s) *
Your answer
Home Church Affiliation *
Emergency Contact *
Your answer
Emergency Contact's Relationship to participant
Your answer
Emergency Contact's Phone Number *
Your answer
People (other than parents listed above) who may pick up this participant
Your answer
Medical Release (*Required to attend VBS) *
Required
Photo Release
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