Safari with God VBS registration
July 17-20, 2017
9am - noon
St. Martin Lutheran Church
813 Bay Rd. Webster, NY 14580
Contact us: 585-671-1899 (office) or Sharon Haffen 585-703-1441
Email address
Name
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Grade (September 2017)
Youth Shirt Size
Parent/Guardian Name(s)
Your answer
Mailing Address
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Primary Phone Number
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Secondary Phone Number
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Emergency Contact Name
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Emergency Contact Phone
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Person Responsible for Pickup
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Person Responsible for Pickup Phone
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Allergies or special considerations
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Church Affiliation (if any)
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How did you hear about VBS?
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Waiver
I understand any pictures taken at VBS may be used in print or digital media to advertise our church’s programs. Please contact the church if you would prefer images of your child not be used for these purposes
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