2013 Vacation Bible School Registration Form August 5-9, 2013 6:30-8:30pm Name__________________________________ Date of Birth___________________
Gender______
Age____
Last Grade Completed________________
Church Affiliation____________________________________________________ Name(s) of Parent(s)/Guardian(s)_______________________________________ Address____________________________________________________________ ___________________________________________________________ ___________________________________________________________ Home Phone_____________________ Cell/Work Phone_________________ Contact Information in Case of Emergency________________________________ __________________________________________________________________ Medical or Allergy Concerns___________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ Prayer Requests _____________________________________________________ __________________________________________________________________ Are there any needs that Faith Lutheran Church can assist you with? __________________________________________________________________ __________________________________________________________________ Do we have permission to photograph your child, which could be used for future promotions of VBS? Yes_____ No_____