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St. Dunstan's Episcopal Church, Atlanta, Georgia

Register for Vacation Bible School at St. Dunstan's,
June 9-13, 2008—9:00 a.m. ~ 12:30 p.m.

[Optional BYO lunch, 12:30 ~ 1:00 p.m.]

Click here if you prefer to print a version of this form to mail or drop off at the church.

Please send a check in the amount of $25.00 made out to "St. Dunstan's Episcopal Church" and mail the check to the following address:

4393 Garmon Road, NW
Atlanta, GA 30327

 
  Parent Information
Name:
Email:
   
Address:
City:
Zip:
   
Home Phone: (with area code)
Cell Phone: (with area code)
Work Phone: (with area code)
   
  Children's Information

First Student Name:

Birth date:

Year in School:

Age:
__________________________________________________
 

Second Student Name:

Birth date:

Year in School:

Age:
__________________________________________________

Third Student Name:

Birth date:

Year in School:

Age:
__________________________________________________

Fourth Student Name:

Birth date:

Year in School:

Age:
__________________________________________________
  Emergency contact #1
Name/Relation:
Phone: (with area code)
   
  Emergency contact #2
Name/Relation:
Phone: (with area code)
   
  __________________________________________________
   
  Dismissal information (Names of those who may pick up this child from VBS.)
 
   
  __________________________________________________
  Do any children have any food allergies or health concerns that we should know about?
  Yes (Please elaborate below)
  No
   
 

Is there anything else you would like your child's VBS teacher to know about your child?
Message:
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