St. John Lutheran Church
August 4 - August 8, 2008 9 a.m. to Noon
300 W. Maple Road
Linthicum, Maryland 21090

“Rainforest Adventure”
Vacation Bible School Registration - COMPLETE ONE FORM PER CHILD
Ages 3 as of (Sept. 1, 2007) to completed 5th grade

Name_______________________________________________________________________________


Birth Date__________________________________ Last school grade completed_______________

Parent/Guardian Name________________________________________________________________

Address____________________________________________________________________________

Home Phone_______________________

Work Phone_______________________

Does child have any known allergies or medical concerns?_______________________________

___________________________________________________________________________________

Emergency Phone___________________________________________________________________

Health Care Provider/Phone___________________________________________________________

Does the student attend Sunday Church School?________________________________________

If so, where?________________________________________________________________________

THIS FORM AUTHORIZES ST. JOHN LUTHERAN CHURCH TO OBTAIN MEDICAL
TREATMENT IN CASE OF EMERGENCY.

Parent/Guardian Signature______________________________________________

Date _________________________________________________________________

Make your check payable to St. John for a donation of $5.00 and register by July 1st

My child (6th grade or older) would like to be a teen helper:_______________________________

 

PLEASE PRINT THIS FORM, FILL IT OUT AND TAKE OR MAIL IT WITH YOUR CHECK TO ST. JOHN CHURCH OFFICE.