PSCC VBS : St Mark Lutheran Church

Child's Info

Name(Required)

First Last

Birthdate(Required)

T-Shirt Size(Required)

Gender(Required)

Male

Female

What grade are they entering this fall?(Required)

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Does your child have any food allergies?(Required)

Yes

Please explain(Required)

Are there any medical issues we need to be aware of?(Required)

Yes

Please explain(Required)

Name of Family Doctor(Required)

Doctor's Phone(Required)

Please list any persons other than the registering parent who may pick this child up from VBS.(Required)

Parent's Info

Name(Required)

First Last

Home Address (if different than above)

Street Address Address Line 2 City State ZIP Code

Primary Phone Contact(Required)

Secondary Phone Contact

Primary Email(Required)

Secondary Email

Digital Signature(Required)

Please type your full legal name. This constitutes a legal digital signature.

Volunteer?

Are you able to volunteer?(Required)

Yes

Which day(s)?(Required)

Monday

Tuesday

Wednesday

Thursday

Friday

• Check areas in which you feel comfortable assisting the section leader:(Required)

Craft

Music

Snacks

Playground Supervisor

Games

Age-level helper (stays with same group of kids all morning)

Skits

Anything!

CAPTCHA

St Mark VBS Signup

Child's Info

Parent's Info

Volunteer?