We are so excited your child will be attending
Vacation Bible School, June 17-21, 2019
at Christ The King Lutheran Church, 16700 Pennsylvania Rd. 
(PLEASE NOTE: the Pennsylvania Rd. location)
We gather Monday through Friday from 9:00 AM - 11:30 AM.  
Please arrive early the first day your child attends so we can check them in.
We are thrilled to share our fun theme this year -
"ROAR"

Please type your child's name.

Parent/Guardian Name

Address (Street, City & Zip)

Parent/Guardian Phone #

Cell Phone #

Email Address

Grade Just Completed

DOB

Any Allergies?

Male or Female ?

Choose... 1. Male 2. Female

Are there any Medical Concerns?

Additional Emergency contact different from Parent/Guardian? Name & Phone #

Does you child have a classroom assignment request?

List any sibling attending VBS and their just completed grade.

I agree to let my child's picture be used in publicity for Christ The King Lutheran Church VBS?

Choose... 1. yes 2. no