Atonement VBS Registration Form
Welcome to Vacation Bible School at Atonement Lutheran Church!! We are excited to have your family experience the ride of a lifetime with God at Rolling River Rampage. This white water rafting themed adventure includes memorable Bible stories, new music, creative crafts, fun recreation, and much more. Children will enjoy a week of fellowship with others while traveling through the Bible.

Details:
Atonement Lutheran Church, Wyomissing
June 18-22
8:45 - 11:30 AM
age 3 - grade 5

Child's Name *
Your answer
Parent/Guardian Name *
Your answer
Address *
Your answer
Email Address *
Your answer
Phone number (home)
Your answer
Phone number (Cell) *
Your answer
Age Information
Date of birth *
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Age *
Your answer
Last school grade completed (if applicable)
Your answer
Emergency Contact
Please list at least one person who could be contacted if the parent/guardian cannot be reached in the event of an emergency.
Name *
Your answer
Phone *
Your answer
Name
Your answer
Phone
Your answer
Other Information
This helps us meet the needs of all of our children.
Special needs/allergies/medical information/other *
Your answer
Home church
Your answer
Siblings or friends attending VBS
Your answer
Dismissal Information
The safety of all of our children is important to us.
Name(s) of person(s) who may pick up this child from VBS *
Your answer
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