2007 vbs

Calvary Lutheran Church
2007 Vacation Bible School

July 30 to Aug 3 - 9:00 AM to Noon
Registration Form

Please submit once for each child
Call (510) 278-2555 M-F 8:30AM-4:30PM for more information
You may also print this form and mail to:

Calvary Lutheran Ministries
17200 Via Magdalena
San Lorenzo, CA 94580

Child's Name

Grade Completed

Birthdate Age

Parents' Names

Home Address

Home Phone Alternate Phone

Emergency Contact Person

Contact Relationship to Student

Contact Home Phone Alternate Phone

Food Allergies:
No
Yes, explain

Medical Concerns:
No
Yes, explain

Family Doctor Doctor's Phone

Siblings Attending VBS (names and ages)

Church Affiliation

Church Membership At

People who may pick up the child

Days attending:

Day 1 Day 2 Day 3 Day 4 Day 5

Photo waiver:
I hereby grant the VBS leaders permission to photograph/videotape the minor(s) designated above for any lawful purpose associated with this VBS program.

or EXIT