VBS Registration - 2019

VACATION BIBLE SCHOOL
(AGE 4-ENTERING GRADE 5)

June 17-20, 2019 (new this year—Monday-Thursday)
9:00 a.m.–11:30 a.m., First Presbyterian Church of La Grange

Daytime Phone *
Daytime Phone
Alternate Phone
Alternate Phone
Address
Address
Member of FPCLG?
1. Child's Name (Enter additional children below)
1. Child's Name (Enter additional children below)
Birthdate
Birthdate
Food allergies or medical concerns?
2. Second Child's Name
2. Second Child's Name
Birthdate
Birthdate
Food allergies or medical concerns?
3. Third Child's Name
3. Third Child's Name
Birthdate
Birthdate
Food allergies or medical concerns?
4. Fourth Child's Name
4. Fourth Child's Name
Birthdate
Birthdate
Food allergies or medical concerns?
Emergency Contact Person *
Emergency Contact Person
Please list emergency information for your child(ren) in the event you are not available.
Contact's Daytime Phone *
Contact's Daytime Phone
Contact's Alternate Phone
Contact's Alternate Phone
Parental Permission *
Mon., July 25– Thu July 29, 2016, 9a.m.– 12p.m. Friday, July 29, 2016, 9am—12pm & 5:30—7pm*   *Family VBS Closing Ceremony & Dinner Friday Night   Age 4  (by July 25,2016)  to Grade 5  (2016-2017 School Year)  $32/Child (Sugg’d. donation); $82 Max./Family *After July 10—$42/Child & $92 Max./Family