Vacation Bible School 2018

Vacation Bible School
June 25th – 29th 9:00 am – 12:00 pm
Are you ready to venture onto an
uncharted island where kids survive and thrive?

The theme for this year’s Vacation Bible School is “Shipwrecked: Saved by Jesus”.
Kids in grades Pre-K through 5th grade are welcome to attend.

Thank you for registering for Vacation Bible School!

Child's Full Name
Grade this Fall:
Pre-KKindergarten1st2nd3rd4th5th
Child's Birthdate
Your Name
Your e-mail *
Home Address
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Parent/Guardian Phone number *Please enter the best phone number we can use to reach you.
Parent/Guardian Phone Number *Please enter the best phone number we can use to reach you.
Emergency Contact Information
In case of emergency, please list: Two contact persons, their relationship to the child and their phone number.
Medical Information
Please list any special diets, allergies, medications, restrictions of activities or behavior behavior issues that we should be aware of.
Permission
In the event that I can't be reached, I authorize Salem Lutheran Staff and/or Volunteers to obtain medical care for my child. Please list your child's: Doctor's name and phone number, medical insurance carrier and medical insurance policy #.
I give permission for my child's photo be taken for publicity purposes.
YesNo
Text

Verification

Please enter any two digits *Example: 12
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