Shepherd of Peace Lutheran Church
520 Village Park Dr.
Powell, Ohio 43065
Phone: 614-786-7226
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Registration - Vacation Bible School
Parent(s) name:
*
Mailing Address:
*
Contact Phone:
*
Contact Email:
*
Church Affiliation:
*
Emergency Contact Name (if different from above):
Emergency Contact Number (if different from above):
Child #1 Name:
*
Child #1 Grade:
*
3 years old (potty trained)
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
Child #1 t-shirt size:
*
Child #2 Name:
Child #2 Grade:
3 years old (potty trained)
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
Child #2 t-shirt size:
Child #3 Name:
Child #3 Grade:
3 years old (potty trained)
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
Child #3 t-shirt size:
Child #4 Name:
Child #4 Grade:
Preschool
Kindergarten
1st
2nd
3rd
4th
3 years old (potty trained)
5th
6th
Child #4 t-shirt size:
Please list any allergies that any of your children have:
Name of Family Doctor:
*
Doctor's Phone Number:
*
Preferred Hospital:
*
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For it is by grace you have been saved, through faith—and this is not from yourselves, it is the gift of God— ~ Ephesians 2:8 (NIV)