2019 Oak Grove Presbyterian Vacation Bible School Registration Form
God Sightings! God’s love is everywhere – in acts of service, in others, in unexpected places and in ourselves. Come, explore and experience God’s love during VBS!

EARLY REGISTRATION IS RECOMMENDED. Registrations are due NO LATER than Wednesday, June 5.

DATE: Monday – Thursday, June 10 - 13, 2019 (for children ages 3 years through 5th grade), 9 am - Noon

OAK GROVE PRESBYTERIAN CHURCH
2200 WEST OLD SHAKOPEE ROAD, BLOOMINGTON, MN 55431

Questions: please contact Mary Koon at 952-888-4621 or mkoon@oakgrv.org

Cost: $20.00 ($ 40.00 total per family) payable by cash, check, or credit card. Please indicate below how you would like to pay. Checks may be mailed to the church office or delivered in person.

Scholarships are available. Contact Mary at mkoon@oakgrv.org or 952-8884621 for information.

Deadline to register is June 5, 2019

Child#1 Name *
Your answer
Child #1 Date of birth *
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Child #1 Grade (Sept 2019) *
Your answer
Child #2 Name
Your answer
Child #2 Date of birth
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DD
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YYYY
Child#2 Grade (Sept 2019)
Your answer
Child #3 Name
Your answer
Child #3 Date of birth
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DD
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YYYY
Child #3 Grade (Sept 2019)
Your answer
Parent Name *
Your answer
Parent address (Street, City, Zipcode) *
Your answer
Parent cellphone *
Your answer
Parent daytime phone
Your answer
Parent email *
Your answer
Emergency contact name *
Your answer
Emergency contact relationship to child *
Your answer
Emergency contact cellphone *
Your answer
Emergency contact daytime phone *
Your answer
Health history (do you have any concerns you would like to share?)
Your answer
Allergies - please list any allergies of Child #1 (if none, write none below). Please list allergy, reaction, treatment, and other comments. *
Your answer
Allergies - please list any allergies of Child #2. Please list allergy, reaction, treatment, and other comments.
Your answer
Allergies - please list any allergies of Child #3. Please list allergy, reaction, treatment, and other comments.
Your answer
PHOTO RELEASE: Throughout the program your child(ren) may be in photos or videos which may be used in flyers, newsletters, or on the website at the church. Names WILL NOT be identified. Do you give permission for them to be in these photos? *
Payment method *
Electronic signature - please type your name below if you are signing as the parent or guardian to enroll the child (children) in Oak Grove VBS *
Your answer
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