St .Andrew Lutheran Church- Middleton, WI ť 2010 Vacation Bible School Registration

WELS

St. Andrew Lutheran Church

Flash: ON

September 8, 2010


	Contact Info:

St. Andrew Lutheran Church
6815 Schneider Rd
Middleton, WI 53562
Phone: (608) 831-8540
Contact Via Email


	Navigation:


	User Login:

User Login


	2010 Vacation Bible School Registration

Children must turn four on or before 9/1/2010 to be enrolled in VBS.
*required field
VBS Location*
Middleton July 26-30, 9:00-11:45 AM Waunakee August 2-5, 5:30-7:30 PM
Student Information
Child's full name*
Grade entering for the 2010-2011 School Year*
Birthday* (mm/dd/yyyy)
Parents' full names
Address*
City, State, Zipcode*
Primary phone*
Alternate phone
Primary email address:
Emergency and Authorized Pickup Information
Contact person if parents cannot be reached:
Relationship to student
Primary phone*
Alternate phone
Medical Information
Food Allergies*
If so, what?
Medical concerns*
Please explain any medical conditions.
Family doctor
Doctor's phone
Church Information
Home church

Please enter the characters from the box above: