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Home
Zelienople-Harmony Lutheran Ministry
About Zion
Worship Service Information
Calendar of Events
Newsletter
Sermons
Greeter & Usher Schedule
Programs
Southwest Butler Food Cupboard
Members and Staff
Contacts and Location
Flower Order Form
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ZION LUTHERAN CHURCH
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Home
Zelienople-Harmony Lutheran Ministry
About Zion
Worship Service Information
Calendar of Events
Newsletter
Sermons
Greeter & Usher Schedule
Programs
Southwest Butler Food Cupboard
Members and Staff
Contacts and Location
Flower Order Form
In conjunction with English Lutheran and St Paul Lutheran, Zion will host a 2019 Vacation Bible School on July 15-18 from 9am to noon each day.
Complete the form below and be sure to hit the "Submit" button to email your child's registration form to Zion.
*
Indicates required field
Child's Name
*
First
Last
[object Object]
Age
*
3
4
5
6
7
8
9
10
11
12
children between 3 years old through completion of 5th grade are eligible
Grade Entering This Fall
*
Enter pre-school if not in K-5
Child's T-Shirt Size
*
Child Small
Child Medium
Child Large
Child X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Gender
*
Male
Female
Home Congregation (if applicable)
*
Parent/Guardian Name
*
First
Last
Willing to volunteer to help? Choose all that apply
*
Leader
Aide
No Thanks
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Home Phone
*
enter "none" if no home phone
Cell Phone
*
enter "none" if no cell phone
Other Phone Number
*
Email
*
Emergency Contact Name (other than parent/guardian)
*
First
Last
Phone Number
*
Alternate Person Picking-up Child
*
First
Last
[object Object]
Phone Number
*
List any allergies or medical needs that the child has
*
List anything special you'd like us to know about your child
*
Optional: It would be nice if my child is placed in the same group as (other child's name)
*
First
Last
A daily offering will be collected for a local mission. Please bring a canned good each day for the Food Cupboard.
--Medical Release: I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me.
--Photo Release: I hereby grant the above named church permission to copyright and use photographs/videos taken at VBS of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.
--Permission to Attend: I give permission for my child (named above) to attend the Vacation Bible School (VBS) listed above. I understand that the information I give for this registration will only be used by the VBS hosting church, and that all registration information will be removed from the hosting site by December 31 of this year.
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