August 7-11, 2017
6:00 pm - 8:00 pm
23225 Gill Road 
Farmington Hills, Michigan 48335 
Phone: (248) 474-0584 
Email: OM@stjohn-elca.org
Register now
 
Registration Contact Name *

Who we should contact if we have any questions or issues regarding registration
 
Street address *

 
City *

 
State *

 
Zip code *

 
Primary phone number *

 
Secondary phone number *

 
Home church

 
VBS Participant #1

 
Name

 
Birth Date

 
Grade in fall (if applicable)

 
Allergies or other medical conditions

 
VBS Participant #2

 
Name

 
Birth Date

 
Grade in fall (if applicable)

 
Allergies or other medical conditions

 
VBS Participant #3

 
Name

 
Birth Date

 
Grade in fall (if applicable)

 
Allergies or other medical conditions

 
VBS Participant #4

 
Name

 
Birth Date

 
Grade in fall (if applicable)

 
Allergies or other medical conditions

 
In case of emergency, contact *

 
Emergency contact phone number *

 
What is {{answer_nVl8viVUlKM9}}'s relation to the registered VBS participants? *

Thanks for completing this typeform
Now create your own — it's free, easy & beautiful
Create a <strong>typeform</strong>
Powered by Typeform