HOMETOWN NAZARETH WHERE JESUS WAS A KID

Ages 3 - 11

DATE:  June 13 - 17, 2011
TIME:  5:30 - 8:00 pm  (Dinner Too)
PLACE:  Grace Lutheran Church, 6601 N 9th Ave.

REGISTRATION FORM

VACATION BIBLE SCHOOL - 2011

VACATION BIBLE SCHOOL -Scheduled for June 13 - 17, 5:30 PM - 8:00 PM.  Dinner will be served each night.  Freewill offering  See Amy Onkka for details or call 505-7735 (weekdays) or 529-4863 (cell)

Want more information on the curriculum?  Click here.

 

EACH CHILD MUST BE REGISTERED SEPARATELY!

nter the event:

Child's Name:

Last School Grade Completed:

Child's Date of Birth:

Child's Age:

Home Address:

Home Phone:

Alternate Phone

Emergency Contact Person

Emergency Contact Relation To Child:

Emergency Contact Home Phone:

Emergency Contact Alternate Phone:

Food Allergies (Yes or No, if Yes, list)

Medical Concerns (Yes or No, if Yes, Explain)

Family Doctor


Family Doctor's Phone

Siblings Attending VBS, Names and Ages

Parents:

Parents Address - City, State Zip:

Home Church:

Your email address:

People Who May Pick Up The Child:

EACH CHILD MUST BE REGISTERED SEPARATELY

VBS leaders have permission to photograph/film the minor designated above in any manner or form for any lawful purpose associated with this VBS program.

 

Thank you for registering.