VBS Monumental
This form is to Register for VBS sponsored by Peace Evangelical and Reformed Church.

July 11-15 from 8:30 am - 12:00 pm at Camp Forest in Forest Junction WI.

$15 per child for t-shirt, food, and CD (increase to $20 after June 12)

Send check to Peace E & R also payable to same.

Or send venmo to @Tara-Bruckner

Tara Bruckner
920.418.4650
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Parent Info
Parent Last Name, First Name *
Parent Best Cell Phone for Contact *
Parent Best Email for primary communication. *
Person transporting student(s) to vbs with phone number? *
Emergency Contact Name and Phone Number   *
Student #1 Info
Student #1 Last Name, First Name *
Student #1 Grade in 2021-2022
Student #1 T shirt size *
Student #1 Allergies/ Medical/ Behavior to be shared for child's best experience: *
Student #2 Info
Student #2 Last Name, First Name
Student #2 Grade in 2021-2022
Student #2 T shirt size
Clear selection
Student #2 Allergies/ Medical/ Behavior to be shared for child's best experience:
Student #3 Info
Student #3 Last Name, First Name
Student #3 Grade in 2021-2022
Student #3 T shirt size
Clear selection
Student #3 Allergies/ Medical/ Behavior to be shared for child's best experience:
All other Students
If you have more than 3 children please add their names, t-shirt size and allergy info here.
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