Wufoo

2008 Emmanuel Lutheran Elk River VBS Registration

VBS is June 16th to 21st 6:00pm-8:30pm. Please fill out the form completely. Any problems or concerns call Phil and Michelle Kolterman at 763-441-2070 or email mlkk2000@msn.com

Child's Name *

Please enter your childs name
Grade Completed & Age *

Enter the most recent grade completed
Parent Or Gaurdian's Name *

Name of the childs parents.
Parent Or Gaurdian's Email

Phone number of the alternate emergancy contact.
Home Address *

Child's home address for mailings
Home Phone(s) * ### - ### - ####
Please enter any phone numbers that might be needed to contact the parents
Alternate Emergency Contact and contact information *

Alternate person to contact in case of emergancy.
Medical concerns or allergies

Any medical concerns that the VBS team needs to be aware of.
Church affiliation *
Any notes or concerns we should be aware of?
Do Not Fill This Out
Do Not Fill This Out