Lone Rock Bible Church VBS 2024 Student Registration Form - Camp Kilimanjaro
Sunday, June 23 through Thursday, June 27
5:00pm - 8:00pm
Dinner at 5:00pm
Ages 5-12 (as of June 23)
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Email *
Child's LAST Name  *
Child's FIRST Name  *
Age as of June 23, 2024 *
Mailing Address (street, town and zip code) *
Parent/Guardian Name & Phone *
Emergency Contact (Name, Phone & Relationship to Child) *
Is there anyone by whom your child CANNOT be picked up? *
Any food allergies? (Please list) *
Any medical concerns we need to know about? (if yes, please explain) *
I'd love for my child to join you for dinner! We'll have a GF and Dairy Free option available.  We won't be able to accommodate any other food allergies. You are welcome to send dinner with your child or just join us at 5:20pm. *
Gluten Free
Dairy Free
No dinner for me! Thanks!
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