St. John's 2018 Vacation Bible School "Team Spirit" Student Registration
VBS Schedule: June 4-8, 2018, 8:30-11:30 am
VBS Location: St. John's Lutheran, Church, 229 S First St., Pearl City, IL 61062
VBS Contact: St. John's at 815-443-2215 or prshadmin@gmail.com
Please register by May 13, 2018 to insure sufficient materials and t-shirt availability.
Email address *
Name of Parent or Guardian *
Your answer
Address (include city, state & zip) of Parent or Guardian *
Your answer
Contact Phone Number of Parent or Guardian *
Your answer
Person responsible for pick-up (include phone number) *
Your answer
1st Child's Name *
Your answer
1st Child's Date of Birth *
MM
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DD
/
YYYY
1st Child's Grade (2017-18 School Year) *
Your answer
2nd Child's Name
Your answer
2nd Child's Date of Birth
MM
/
DD
/
YYYY
2nd Child's Grade (2017-18 School Year)
Your answer
3rd Child's Name
Your answer
3rd Child's Date of Birth
MM
/
DD
/
YYYY
3rd Child's Grade (2017-18 School Year)
Your answer
4th Child's Name
Your answer
4th Child's Date of Birth
MM
/
DD
/
YYYY
4th Child's Grade (2017-18 School Year)
Your answer
Any days that your children will not attend?
Dietary restrictions (please note for which child)
Your answer
Allergies or Medical Needs (please note for which child)
Your answer
"Team Spirit" VBS T-shirts available at $6 each (please check all sizes needed)
If additional quantities of any shirt size is needed. Note here: (Size and Quantity)
Your answer
Any special notes or directions to the VBS Leader:
Your answer
I understand that I will have to pay $$ upon arrival for any t-shirts that are ordered. No participation fee. *
Required
I understand that in the event of an emergency or medical care becomes necessary, every attempt will be made to contact someone. If unable, I grant the adult volunteers of St. John's Lutheran Church VBS authorization to secure medical attention. I also give my permission for my child's photo to be used in promotional materials and in social media by St. John's. *
A copy of your responses will be emailed to the address you provided.
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