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2024 Vacation Bible School by Zion & Emmanuel Lutheran Churches
Event Timing: May 20th, 21st, 22nd, 2024. 6:00 pm to 8:00 pm each evening.
Event Address: Zion Lutheran Church, 492 7th Street, Phillipsburg, KS 67662
Contact us at (785) 543-2005
www.zionlutheranchurchofphillipsburg.org
zionlu@ruraltel.net
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* Indicates required question
First & Last Name of Child
*
Please fill out a separate form for each child
Your answer
By what name does the child like to be addressed?
Your answer
Age of child on May 20, 2024
*
Age 4 (must be toilet trained)
Age 5
Age 6
Age 7
Age 8
Age 9
Age 10
Other:
What grade will the child be entering in Fall 2024?
*
Preschool
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
Names of legal parents and / or guardians
*
Your answer
Name of person completing this form and relation to child.
*
Your answer
Parents' or guardians' phone numbers that will be monitored during scheduled VBS times:
*
Your answer
Can these or one of the numbers receive texts?
*
Yes
No
Parents' or guardians' email addresses
Your answer
Parents' or guardians' physical address:
*
Your answer
What evenings does your child plan to attend?
*
Check all that apply
Monday, May 20, 2024 from 6 pm to 8 pm.
Tuesday, May 21, 2024 from 6 pm to 8 pm.
Wednesday, May 22, 2024 from 6 pm to 8 pm.
Required
Besides legal parents or guardians, who is allowed to pick-up your child or have outside contact with him or her?
*
Your answer
Does your child have any food allergies?
*
Yes
No
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