Winter VBS Complete Registration Form | Community Lutheran Church

Please complete a separate form for each child.

VBS Complete Registration Form

Child's Name

Child's Age

Child's Birth Date

Child's Grade

Parent/Guardian Name(s)

Additional Family Members

Home Number

Cell Number

Work Number

Preferred Contact Method

Home Church (if any)

Emergency Contact 1

Phone

Emergency Contact 2

Phone

Doctor

Phone

Allergies or Special Needs

Who may pick up your child at the beginning and end of each VBS day?

Name

Relationship

Name

Relationship

I understand for my child to attend, I must complete and return the attached form.

Yes

This form must be completed, signed, and submitted on the first day of VBS or before.

If you are human, leave this field blank.