Family Registration for Vacation Bible School
at Hope Lutheran Church Contact: 503 951 0778
Parent Names ______________________________________________
Phone ____________________________________________________
Address ___________________________________________________
Names _____________________________age________
______________________________age________
______________________________age________
______________________________age________
______________________________age________
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_____We regularly attend church. Church Name__________________
_____ We do not regularly attend church.
In case of emergency, call: ___________________________________
Phone _____________________Relationship____________________
Medical or behavior problems or allergies:
____________________________________________________________________________________________________________________
Names of adults who have permission to pick up my children:
__________________________________________________________
__________________________________________________________
In case of medical emergency the staff of Vacation Bible School at Trinity and/or Hope Lutheran Church is authorized to secure lifesaving emergency medical treatment and/or transport for my child and will notify me immediately. Other instructions:
__________________________________________________________
Parent signature Date