1. Our Saviour Lutheran
VBS Registration Form
There is a registration fee of $10 per child or $20 per family.
Please return registration forms to the office by Sunday, May 24!
Mon., June 29 – Thur., July 2, 2009 9:00am–12:00pm (Three year olds must be 3 by Sept. 1, 2008 and be toilet trained.)
(Current PK-grade 5) (One form per Family, please)
1.) Name: _______________________________________________
Parent / Adult Information:
Grade completed: ________ Birth date: ___________ Age: ________
Name(s):_________________________________________________
Any Food Allergies or other Medical problems: _________________
Address:_________________________________________________ ________________________________________________________
Home Phone:__________________ Alt. Phone:_________________
2.) Name: _______________________________________________
E-mail address:____________________________________________
Grade completed: ________ Birth date: ___________ Age :_______
Church Membership at:_____________________________________
Any Food Allergies or other Medical problems: _________________
I am interested in assisting with VBS on the (circle all areas where you ________________________________________________________
would be willing to assist): Planning Team, Administration Team,
Decorating Team, Snack Team, Teaching Team, Music Team, Craft Team,
Recreation Team, Storytelling Team 3.) Name: _______________________________________________
Emergency Information: Please list emergency information for the Grade completed: ________ Birth date: ___________ Age:________
child(ren) in the event that you are not available.
Any Food Allergies or other Medical problems:__________________
Emergency Contact Person:__________________________________ ________________________________________________________
Relationship to Child(ren):___________________________________
4.) Name: ________________________________________________
Home Phone:_____________________ Alt. Phone:_______________
Grade completed: _________ Birth date :___________ Age:_______
Family Doctor:___________________ Phone:___________________
Any Food Allergies or other Medical problems: __________________
Contact Donna Biebel @ 468-5547 with any questions. ________________________________________________________