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Weekday Kids - Bible School Form
 
NURSERY SCHOOL CHILD CARE CENTER K TO 3RD YOUTH CLUB
KIDS' CHOIRS YOUTH HANDBELLS
4TH TO 8TH YOUTH CLUB VACATION BIBLE SCHOOL
     
 

VACATION BIBLE MISSION SCHOOL FORM
Please use the form below to register your children for Vacation Bible Mission School. You may complete the form on line or you may print the form and include it with your payment.

Advance registration is required. Please submit a separate registration form for each child. Mail the payment by July 21, 2008, for all participating children to:

   Vacation Bible School
   Southminster Presbyterian Church
   799 Washington Road
   Pittsburgh, PA 15228.

The program will take place July 28 - August 1 from 9 a.m. to noon at Southminster. The fee is $5 per child.  Please make the check payable to Southminster Presbyterian Church.  Please contact Peggy Wucher at 412-343-8900 for further information.

Child's Name:
Nickname:    Date of Birth: 
Age:                          Sex:  
Grade Completed:
Address:
City & ZIP:
Home Phone:
Home Email:

Mother's Name:
Cell Phone:    Office Phone: 
 
Father's Name:
Cell Phone:    Office Phone: 

In case of emergency, contact:

Does your child have any allergies, medical conditions or special needs?

Cost includes a t-shirt.  Please indicate size:   Other Size:

Please fill in this form and press the submit button
   
  Thank You

Page last updated:08/05/08