microsoft word - vbs registration 2018.doc · web view2019-05-16 · sunday-thursday 6:15p-8:30p...
TRANSCRIPT
Sunday-Thursday 6:15p-8:30p Registration Fee $10 per child T-Shirts Available Separately—
Please contact the church office at 218-4646 or [email protected]
Come join us and feel how life changing being rescued by Jesus can be!
Child’s name (one child per form): Grade Entering: _
Gender: _ Date of birth: _
Allergies: Other medical conditions:
Name of a friend child would like to be with:
Parent name: Phone number:
Home Church: Email address: _
Address: City: State: Zip:
EMERGENCY CONTACT (other than parent listed above):
Name: Relationship: Phone: _
Photo authorization: I do hereby assign all rights, privileges and materials for reproduction to Christ Community Lutheran Church (CCLC), for any or all photographs taken of me by CCLC or its recognized agents. I further grant CCLC the right to use my name and likeness in its publications and/or website and related products and services.
Signature: _
Church use only:
Entered: Date: Paid: Date: