VBS (Age 3 Years to Pre-K) ~~~ DayCamp (K-5th)

Monday-Wednesday, June 30-July 2
- Pre-School (9:00-11:00 am) $20
- Completed Kindergarten-5th (9:00-3:00 pm) $60

Registration period: Now to May 1
Limit to the first 50 children.

All communications to parents during the week will be via email. Please check your email regularly during the week!

Child #1 Child #1 * First Last
VBS/Day Camp for Pre-School or Kindergarten-5th *

VBS/Day Camp for Pre-School or Kindergarten-5th Pre-School (9:00-11:00 am) VBS Completed Kindergarten-5th (9:00-3:00 pm) Day Camp
Child #1 *

Child #1 Male Female
Date of Birth (Child #1)
Date of Birth (Child #1)
* / MM / DD YYYY
Grade just finished - Child 1 (if applicable)
Child #2 Child #2 First Last
VBS for Pre-School or Kindergarten-5th

VBS for Pre-School or Kindergarten-5th Pre-School (9:00-11:00 am) Completed Kindergarten -5th (9:00-3:00 pm)
Child #2

Child #2 Male Female
Date of Birth (Child #2)
Date of Birth (Child #2)
/ MM / DD YYYY
Grade just finished - Child 2 (if applicable)
More than 2 children in your family....

please fill out this form again. Thank you
Allergies/Restrictions on any of your children?
Scholarship Needed?

Scholarship Needed? Yes, I need a scholarship. No, I do not need a scholarship.
Can Volunteer with VBS (Volunteers children will get first priorty.) *

Can Volunteer with VBS (Volunteers children will get first priorty.) Yes, I can help with VBS No, I cannot help
Parent Name Parent Name * First Last
Cell Phone Cell Phone * - ### - ### ####
Email *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Parent Signature and Date:
LIABILITY/MEDICAL/PHOTO RELEASE:
My children have permission to take part in all VBS/Day Camp activities. I agree that the church, its personnel and volunteers will not be held responsible and hereby release them from any accidents which may occur. In the event I cannot be reached in an emergency and my child requires necessary emergency care, I give permission for deliver of such by available medical personnel. I give permission for my child’s photo to be used for Calvary Lutheran church publicity purposes.

VBS (Age 3 Years to Pre-K) ~~~ DayCamp (K-5th)

VBS (Age 3 Years to Pre-K) ~~~ DayCamp (K-5th)

More than 2 children in your family....