Stellar Shine Jesus' Light Vacation Bible School Registration

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Event Dates: Sunday, July 9th - Thursday, July 13th , 2023
Event Times: 6:00 pm - 8:20 pm
Event Location: Mars United Presbyterian Church 232 Crowe Avenue, Mars, PA 16046
Contact Us: Mars UP (724) 625-1365 or St. Johns Lutheran Church (724) 625-1830

Child's First Name: *

Child's Last Name: *

Date of Birth: *

YYYY

Child's Age: *

Last School Grade Completed: *

Name of Parent(s) / Guardian (s): *

Street Address: *

City: *

State: *

ZIP: *

Home Phone: *

Cell Phone: *

E-Mail *

Emergency Contact Name & Number *

Special Needs or Requests

Crew Assignment (Completed by Church)

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