VBS At Home - Good Shepherd Lutheran Church

Registration Fee is $5.00 Per Child. Payment must be received prior to event.

Choose Payment Option*

Paypal

Cash/Check

Please make it out to Good Shepherd Lutheran Church and note it's for VBS in memo field.

Send to:

Attn Rachel King

501 Fairfield Drive

Greensburg, PA 15601

Send payment to paypal@goodshepherdgbg.org

Deadline to register is June 30th, 2020

*After this date the fee is $10 per child

Must register by June 30th

Select number of Children*

1st Child Name*

First

Last

1st Child Date of Birth*

day

/

month

/

year

1st Child Age*

1st Child Gender*

Boy

Girl

1st Child Last Grade Completed

1st Child T-Shirt size*

Extra Small 2-4

Small 6-8

Medium 10-12

Large 14-16

2nd Child Name*

First

Last

2nd Child Date of Birth*

day

/

month

/

year

2nd Child Age*

2nd Child Gender

Boy

Girl

2nd Child Last Grade Completed

2nd Child T-Shirt size*

Extra Small 2-4

Small 6-8

Medium 10-12

Large 14-16

3rd Child Name*

First

Last

3rd Child Date of Birth*

day

/

month

/

year

3rd Child Age*

3rd Child Gender*

Boy

Girl

3rd Child Last Grade Completed

3rd Child T-Shirt size*

Extra Small 2-4

Small 6-8

Medium 10-12

Large 14-16

4th Child Name*

First

Last

4th Child Date of Birth*

day

/

month

/

year

4th Child Age*

4th Child Gender*

Boy

Girl

4th Child Last Grade Completed

4th Child T-Shirt size*

Extra Small 2-4

Small 6-8

Medium 10-12

Large 14-16

Name(s) of Parent(s)*

Address*

Street Address City State / Province / Region Postal / Zip Code

Phone*

Email*

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