Grace Lutheran Church, Woodstock Illinois

VBS Registration Form
GRACE LUTHERAN CHURCH
1300 Kishwaukee Valley Road
Woodstock, IL 60098
815-338-0554
Fax: 338-0913

Please complete a separate form for each child who will be attending. You may use your browser's back button after receiving the confirmation screen to allow for only changing the child's information. There is a suggested donation of $20 per child, with a maximum of $50 per family. Children receive all materials for the week plus will bring home a CD with all their favorite VBS songs at the end of the week.
July 14 - 18, 2008 9 a.m. - 12 noon

-Cathy Buhrow, Director of Education Ministries

All fields with an "*" must be filled out below before pressing the submit button.

*Child's Name:

*Street Address:

*City/State/Zip:

*Male/Female:

*Telephone(Home):

*Grade entering in fall:

*Date of Birth:

*In case of emergency, contact name:

*Emergency Contact Phone:

Mother's/Guardian Name

Mother's/Guardian Phone:

Cell:

Father's/Guardian Name:

Father's/Guardian Phone:

Cell:

Allergies or other medical conditions:
(Please use the enter key to create line breaks.)

Special Education needs:
(Please use the enter key to create line breaks.)

Home Church:

If attending with a non-member friend, please list the friend's name:

I/we, parent/guardian of , give Grace Lutheran Church permission to use photographs and/or video of my child(ren) for ministry promotional purposes. I understand that promotional photographs and names of those pictured may be submitted to local newspapers or used on Grace Lutheran Church's Web site for publicity purposes. (I understand that by registering online I am giving my consent for Grace’s photograph/video/PR purposes)

*Contact Person Name

*e-mail address:

Would you like to be a VBS volunteer?