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LWC VBS Online Registration
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Child's Name
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First
Last
Grade Child Will Be In Fall 2024
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3-4 year old
Kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
Child's Age
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3 years old
4 years old
5 years old
6 years old
7 years old
8 years old
9 years old
10 years old
11 years old
Parent/Guardian Name
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Cell Phone Number
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JULY 22nd - 26th
6:30-8:30pm
Address
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City
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State
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Zip Code
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Parent/Guardian Email
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Child's Food Allergies
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Emergency Contact Phone #
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Emergency Contact Relationship to Child
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Other Allergies or Medical Conditions
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May we have permission to photograph and/or video your child for use in church publications?
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Yes, you have permission to photograph/video my child.
No, I do not give permission to photograph/video my child.
How many people in your family will be attending the FREE cookout and celebration on Friday, July 26th at 6:30pm?
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9
T-Shirt Size
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Adult XXXXL
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