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Vacation Bible School Registration

Community program hosted at Gethsemane Lutheran Church in Baldwin

July 28-August 1, 2013

Vacation Bible School Registration

Name of Child *
Prefix
First *
Last *
Suffix
Child's Age *

MM
/
DD
/
YYYY
Name of siblings attending VBS
Child's Address *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Child's T-Shirt Size *
 Small 
 Medium 
 Large 
 Extra Large 
 XXL 
Parent's Name *
Prefix
First *
Last *
Suffix
Email Address of Parent
Parent's Phone Number *

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Emergency Contact's Name *
Prefix
First *
Last *
Suffix
Emergency Contact's Phone Number *

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Allergy/Health Conditions
Are you willing to help with VBS all or some of the nights?
(If so, we will contact you)
 Yes, all 
 Yes, some 
 No 
Sponsored by:
Zion Lutheran 698-2707
Gethsemane Lutheran 684-2984
Village Church 688-3333
First Reformed Church 684-2901
Christian Reformed Church 684-2928

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