St. John’s Lutheran Church

Vacation Bible School Registration Form

*Must be 4 years old by September 1, 2008

   Cost:           $25 per child – T-shirt included---- $65 maximum per family
   Number of children                          ____ x $25 = $________     Total                                 $________ ($65 maximum)
 
   T-shirts may be purchased individually for $8     ____ x  $8  = $________
 
    Please indicate T-shirt size and quantity:
    Youth                    _____ Small     _____ Med.     _____ Large
    Adult                     _____ Small     _____ Med.     _____ Large    _____ XL
 
    Please list two emergency contacts:
    Name                                                        Relationship to child(ren)                      phone number
    __________________________             ____________________                    _____________
 
    __________________________             ____________________                    _____________
 

   Please list any allergies or medical concerns of which we should be aware:
 
    ______________________________________________________________________________
 
    Please indicate if you are willing to help with any of the following:
 
  ____ Provide snacks            ____ Registration on first day    ____ Staff nursery                ____ Serve snacks          
            _____ House   Luther Park counselors   ______ Preschool helper     ____Junior counselor
 
    Name: ___________________________  Phone number:  ____________