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Submit to:

Pam Nummela, (913-648-2228 /fax:913-648-2283)
Bethany Lutheran Church, 9101 Lamar Avenue, Overland Park, KS 66207

2008 VBS Student Registration

Overland Park Mission
 Morning VBS
July 21-25, 2008
9:00 am until 12 Noon
(Monday-Friday mornings)

Stilwell Mission
Evening VBS
July 13-17, 2008
5:30-7:30 pm
(Sunday-Thursday evenings)

Everyone is invited from ages 4 to those who have completed Grade 7.  There is no charge to attend.  One child per registration form, please.  PLEASE RETURN BY JULY 1, 2008.
Name:______________________________________ Birth Date:___________________________
Parent/Guardian_____________________________________________________________________
Address:___________________________________________________________________________
City/State/Zip:_______________________________ Phone:______________________________
Email:______________________________________ Church Home:________________________
Please check one: Registering for Overland Park Mission Site ___ or Stilwell Mission Site ___
  CHECK LAST GRADE COMPLETED Check Box Completed Grade 3
  Check Box Preschool (Age 4) Check Box Completed Grade 4
  Check Box Pre-Kindergarten (enters K in 2008) Check Box Completed Grade 5
  Check Box Completed Kindergarten

VBS Registration for Middle School Camp
  Check Box Completed Grade 1 Check Box Completed Grade 6
  Check Box Completed Grade 2 Check Box Completed Grade 7
 

Special VBS Registration For Kids of
VBS Volunteer Staff Only

 Check Box Infant – Two's Nursery Care
  Check Box Three Year Old VBS class

VBS uses a Site Rotation format, so there will not be designated classrooms for each age.  If you would like to register children to be together in the same small group during VBS (i.e. siblings, neighbors, cousins), please indicate on the line below.

I would like my child to be in the same group as: ______________________________________
Requests must be made by July 1 with full name provided.  The child requested must be registered!

Special needs of my child/Allergies ______________________________________________________

Children with severe food allergies are required to bring a safe snack daily from home.

EMERGENCY Form—In case of emergency call:
        1. Name: ____________________________________ Phone: __________________
        2. Name: ____________________________________ Phone: __________________
In the event that the above cannot be reached, I understand my child will be taken to Shawnee Mission Medical Center for any emergency treatment.
Parent/Guardian signature ___________________________________ Date ________________