Registration for Vacation Bible

Vacation Bible School - 2009
"Crocodile Dock "
Where Fearless Kids Shine God's Light

Sponsored by:
First Presbyterian Church and Saint John Lutheran Church
Bellevue, Iowa

Sunday, August 2nd through Thursday, August 6th
5:00 PM until 8:00 PM
at Saint John Lutheran Church

Open to All Youth who are 4 years old through those entering 6th Grade!
Children MUST be 4 years old by May 1st, 2009

Youth entering 7th grade and older are invited to be Crew Leaders or Leaders in Training!!

(* denotes a field that must be filled in)

You will receive a copy of this via email to verify that we have received it.

2009 Registration for Vacation Bible School

Name of Child *
Date of Birth & Grade*
Name of Child*
Date of Birth & Grade*
Name of Child*
Date of Birth & Grade*
Name of Child*
Date of Birth & Grade*
Parent/Guardian Name*
Address*
Phone Number*
Cell Phone
Email Address*
Church Membership
Emergency Contact*
Home Phone*
Cell Phone*
Allergies or Medical Concerns
*Transportation Authorization for 5th & 6th Graders**	Yes-Permission given to transport my child to Saint John Retreat Center No-I do not want my child transported to Saint John Retreat Center form builder


Parent/guardian will be required to sign a transportation authorization form at registration.

QUESTIONS? CALL:

KAY ANN SCHROEDER AT (563) 872-4542
SAINT JOHN LUTHERAN CHURCH AT (563) 872-5849

SHANNON WEDEKING AT 872-3856
FIRST PRESBYTERIAN CHURCH AT 872-4853

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