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Vacation Bible School Registration

Wednesday, May 11, 2022 10:30 PM
Friday, June 17, 2022 11:30 PM

Good Shepherd Lutheran Church 877 Street Road Southampton, PA 18966 United States (map)

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Vacation Bible School Registration Form

Child's Name

First Name

Last Name

Parent/Guardian Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Cell Phone

(###)

###

####

Home Email

Child's Age

Preschool Class (Age) This Year

Last School Grade Completed

Home Congregation (if any)

Emergency Contact Name

When parent/guardian can't be reached

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Relationship to Child

Emergency Contact

One friend they would like (same age) in their class

Please list any allergies (including food allergies) the VBS staff should be aware of:

Person responsible for picking up this child at the end of each VBS day:

First Name

Last Name

Phone

Person responsible for picking up this child at the end of each VBS day:

(###)

###

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Parent Signature

May 7

Family Promise

May 21

Vacation Bible School Registration

Vacation Bible School Registration Form

Location

Office Hours

Contact

Vacation Bible School Registration

Vacation Bible School Registration Form

Family Promise

Special Music Opportunities

Location

Office Hours

Contact