VBS Registration Form
St. Paul's Lutheran Church VBS - July 31-Aug 4, 2017
Student's Name
Your answer
Parent/Guardian's Name
Your answer
Address
Your answer
Email address
Your answer
Phone number
Your answer
Age
Your answer
Date of Birth
MM
/
DD
/
YYYY
Last School Grade completed
Your answer
Home Church
Allergies/Medical Information/Other
Your answer
Emergency Contact #1 (Name & phone #)
Your answer
Emergency Contact #2 (Name & phone #)
Your answer
Who has permission to pick up this child each night from VBS?
Your answer
Submit
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