Vacation Bible School Registration Form
Elim Lutheran Church
July 29 - August 2, 2018
6:00 - 8:30pm
Child's Name *
Your answer
Child's Gender *
Child's T-shirt Size *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Last School Grade Completed *
Your answer
Name of Parent/Caregiver(s) *
Your answer
Street Address *
Your answer
City, State, Zip *
Your answer
Home Phone
Your answer
Cell Phone(s)
Your answer
Email Address
Your answer
Home Church
Your answer
Allergies or other medical conditions:
Your answer
In case of emergency, contact NAME *
Your answer
Emergency PHONE *
Your answer
Relationship to Child: *
Your answer
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