St. Paul's UCC Vacation Bible School Registration - 2009

"Build a Better World"

All Faiths Welcome! Ages 4-12 -- Invite a Friend!

Location (directions): 101 Worthington Rd., Exton, PA 19341 [610-363-7285]

Date: July 27th - 31st; 3:00-5:30PM       Cost: Free!

Three (3) Ways To Register! 1) This online form; or 2) & 3) Click here for mail or fax in form.
 

(One form per child, please)

Child's First Name
 
Child's Last Name
 
Child's Birth Date mmddyyyy
 
Street Address
 
City
 
State
 
Zip
 
Grade Completed
 
Home Phone 610-555-1234
 
Cell Phone 610-555-1234
 

Email Address
 

Parent/Guardian
 
Church Affiliation
 
Emergency Contact
 
Emergency Phone 484-555-1234
 
Person(s) to Whom Child  May Be Released (one per line)
 
Allergies and/or Limitations Our Staff Should Be Aware of
Please type the word "None" if appropriate

 
How did you hear about our VBS?
St. Paul's member/friend     website    newspaper ad
from a friend     other
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St. Paul's UCC main page