VACATION BIBLE SCHOOL REGISTRATION
JULY (TBA), 2010
9AM - 12 Noon

"Theme - TBA"

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 Sue French or Michelle Pester
or leave in the collection plate at church

-   -   -   -   -

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