Vacation Bible School Registration Form

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Hope Lutheran Church - Aug. 2nd & 3rd
Preschool - 5th Grade

Child's Name *

Child's Age *

Date of Birth *

YYYY

Last School Grade Completed *

Parent/Guardian's Name (First & Last) *

Street Address *

City *

State *

Zip Code *

Home Telephone Number *

Parent/Caregiver's Cellphone Number *

Home Email Address *

Home Church

Allergies or other medical conditions

In case of emergency, contact (name): *

Emergency Contact Phone Number: *

Emergency Contact - Relation to Child *

I (we) are interested in attending the Adult Bible Study during VBS. *

Yes

Maybe

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