What is it?
Vacation Bible School is a summer day camp that offers fun, crafts and great life lessons.

Who?
Ages 3 years to 6th grade.

When?
July 5-9, 2010
9am -12 noon

Cost?
$40.00 per Child. Multiple Children $30.00 each. (Scholarships are available

if needed)

Questions contact Shari Bates at: (818) 766-8103
or
Catie Merrill - Director of VBS at: 818-571-6217

Please notify our webmaster of any technical difficulties at: webmaster@faithpresvv.org

Presbyterian Cross Seal

Vacation Bible School Sign up

Please fill out the necessary information for each child.

*Student's First Name	Required.		$30 I have multiple children attending. $40 This is my only child attending. Please call me about a Scholarship. Please make a selection.
*Student's Last Name	Required.
*Student's Birthdate	Required.
My Child is (select one)	Male Female Please make a selection.
*What grade will your child be entering in fall of 2010?				Required.
Contact Information
*Mother's First Name	Required.	*Father's First Name		Required.
*Mother's Last Name	Required.	*Father's Last Name		Required.
*Street Address	Required.	Street Address (if different from mothers)
*City	Required.	City
*State	Required.	State
*Zip	Required.	Zip
*Cell	Required.	*Cell		Required.
*E-mail	Required.	*E-mail		Required.
Health Information (In Case of Emergency)
Contact		Allergies		Yes No Please make a selection.
Relationship		If yes please explain
Home Phone
Work Phone
Doctor
Doctor's Phone
Insurance Carrier		Policy Number


* required fields