PHLC VBS Registration 2022
Use this form to register you child for the Pacific Hills Lutheran Church Vacation Bible School for July 11-15, 2022.  Please fill out one form per child.
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Child's name *
First and last name
Child's Gender
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Child's Age
Date of Birth
DD
/
MM
/
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Last School Grade Completed
Name of Parents
First and last names
Address
Street, City, State and Zip Code of Parents
Home Telephone
Parent / Caregiver's Cellphone
Home Email Address
Home Church
Allergies, medical conditions or special needs
In case of emergency contact
Emergency contact phone number
Emergency contact relationship to child
Enviar
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