2016 Holy Moly! Vacation Bible School at St. John's, Lafayette

Registration Form

The completed form will automatically be emailed to St. John's, Lafayette.

Child's Name *

Child's Name

First Name

Last Name

Grade Level

Child's Name

First Name

Last Name

Grade Level

Child's Name

First Name

Last Name

Grade Level

Parent or Guardian *

Parent or Guardian

First Name

Last Name

Parent or Guardian (cont.)

First Name

Last Name

Parent's Email Address

Phone *

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name

First Name

Last Name

Emergency Contact Phone

(###)

###

####

Special Notes (allergies, special needs, etc.)

Permission *

St. John's Episcopal Church may take photographs during this event. We use these photos to record our history and illustrate church life in our newsletter, on our website, and/or on social media. Please indicate whether or not you give permission for photos of your child/ren to be used in these ways.

I DO give permission

I DO NOT give permission

2016 Holy Moly! VBS Registration

2016 Holy Moly! Vacation Bible School at St. John's, Lafayette

Registration Form