St. Luke’s Lutheran Church

VBS Registration Form
(one per family)
Saturday and Sunday, July 20^th - 21^st, 2024
from 9:00 am until 3:00 pm at St. Luke's Lutheran Church.

Name(s):		Age:
Address:
City:
State:	California Alabama Alaska Arizona Arkansas Colorado Connecticut Delaware Washington,DC Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York N Carolina N Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island S Carolina S Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip:
Phone:
Cell:
Email:
Number of family members participating:
Will parents be helping in other areas?			Select ↓ Yes No
Where?
Emergency Contact:
Phone:
Cell:
Allergies or other medical conditions:
Home Church: