St. Michael Evangelical Lutheran Church

A Supporting Congregation of Emmanuel-St.Michael
Lutheran Grade School & Concordia Lutheran High School
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2008 VBS Registration
Amazon Expedition 
VBS August 4-8, 2008
9:00am-Noon
Children Ages 3 (By September 1)
through Grade 5 (Completed)
Please complete one form per child
Instructions:
Please fill out the form below and click the "Send" button at the bottom of the form. The fields with a red "*" are required fields.
Alternatively, you can download the Microsoft Word or Adobe PDF form and email or turn it in to the Church office
Child’s name:*
Grade completed:*
Birthdate/Year:*
Age:*
Parents’ Names/Guardian:*
Address:*
Home Phone:*
Cell Phone:
Emergency contact person:*
Emerg. contact relationship to student:
Emerg. contact Home Phone:*
Emerg. contact Alt. Phone:
Food allergies:*
(list)
 
Medical Concerns:*
(list)
   
Family Doctor:*
Doctor's Phone:*
Siblings Attending VBS (names and ages):

Church Affiliation:
Church Membership at:
People who may pick up child:*
Transportation needed?
No
Attendance:
1 2 3 4 5
I hereby grant the VBS leaders permission to photograph/film the minor designated above for any lawful purpose associated with this VBS program.

 


If you have questions, comments, suggestions or problems, Send us an email
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Legal Disclaimers