2023 VBS Participant Form

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Welcome back to Vacation Bible School at Redeemer Lutheran Church!
Please fill out the required information so we can enroll your child(ren).
VBS Dates: June 26th through 30th , 9 AM - 12 Noon.
In order to participate you must be 4 years old by July 1st or have just graduated 5th grade.

First Name/Nickname:

Last Name of Child: *

Home Address: *

Home Phone Number: *

Parent/Guardian Name: *

Parent/Guardian Cell Phone Number: *

Email Address: *

Date of Birth: *

YYYY

Male / Female: *

Male

Female

Required

Grade graduating from in June of 2023 *

Emergency Contact: (first and last name) (relationship to child Other than parent or guardian) *

Alternate Pick Up: Name & Phone Number *

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