VBS Registration

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VBS Registration

Fill out and submit the form below to save a spot at our VBS this summer. If you have more than 3 children attending, fill out an additional form. For more information, go to our Frequently Asked Questions page.

Name *
E-mail Address *
Phone (incl. area code) *
Phone #2 (incl. area code) *
Address
City
State
Zip
Child #1 Name *
Child #1 Birthdate (must be before 2/1/2005) *
Medical Conditions or Allergies: *	Yes No
If YES, please explain:
Child #2 Name
Child #2 Birthdate (must be before 2/1/2005)
Medical Conditions or Allergies:	Yes No
If YES, please explain:
Child #3 Name
Child #3 Birthdate (must be before 2/1/2005)
Medical Conditions or Allergies:	Yes No
If YES, please explain:
Additional Comments:
I would like to volunteer to help!	Evening prep sessions in July Decorating Daily setup Supervising children on site Storytelling Crafts Outdoor games Whatever you need! I'd love to, but my schedule doesn't permit it
We are members at (church name):
Church Affiliation:

* Fields marked with an asterisk are required fields

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Messiah Lutheran Church 1605 Vernon Avenue Park Ridge, IL 60068
p 847.823.6984 f 847.823.6996
Office@messiahparkridge.org