VACATION BIBLE SCHOOL
REGISTRATION
JULY 26-30, 2010
9AM - 12 Noon

"BAOBAB BLAST"

NAME ________________________________________________________________________________________________

ADDRESS ________________________________________________CITY __________________  STATE _____   ZIP__________

PHONE # ____________________    AGE ___________________  GRADE COMPLETED  _______________

PERSON TO CONTACT IN CASE OF EMERGENCY: _____________________________________________________________

EMERGENCY PHONE # _____________________________________

Any allergies or special needs? __________________________________________________________________________________

Printout and complete
Return to Pastor Sellers
or leave in the collection plate at church

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Peace-Tohickon Lutheran Church
100 Old Bethlehem Road
Perkasie, PA  18944