VACATION BIBLE SCHOOL June 25-29, 2017 6:30PM–8:30PM AT FRIEDENS LUTHERAN CHURCH 1076 MEMORIAL HIGHWAY OLEY PA 19547 (610)987-6021

AGE 3 THROUGH COMPLETED GRADE 6. AND BACK BY POPULAR DEMAND – ADULT CLASS TOO! PRE - REGISTRATION DUE JUNE 16,2017! Name

Birth date

Address

Zip Code

Home phone

work phone

Emergency phone

School grade completed

Regularly attend Sunday School? Church member?

Where? Where?

Father’s Name

Church

Mother’s Name

Church

Brothers/Sisters (list names and ages)

Please list any allergies/medical conditions this child has:

For staff use only: VBS attendance: 1

2

3

4

5