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VBS & Day Camp Registration Form

July 16-20th

Big Blue Marble: Loving God's Earth

VBS
(4yr - 3rd Grade)
DAY CAMP
(4th - 6th Grade)
COST First Child Per additional child
from same family
First Child Per additional child
from same family
Early Registration
(received by June 10th)
$45 $30 $115 $100
Late Registration
(received June 11th - July 16th)
$55 $40 $135 $120
Parent/Guardian 1 *
Parent/Guardian 1
Daytime Phone Number *
Daytime Phone Number
Parent/Guardian 2
Parent/Guardian 2
Daytime Phone Number
Daytime Phone Number
HSLC Member?
Children Registering for VBS or Day Camp (Must be 4 years old by July 16th)
Student 1 Name *
Student 1 Name
Student 1 Birthdate *
Student 1 Birthdate
This could include food allergies, physical/mental challenges, learning disabilities, first time away from home, custody arrangements, etc.
If your child wants to be grouped with a friend, we will do our best. The other child must be in the same grade, and we can only accommodate one friend request per person.
Student 2 Name
Student 2 Name
Student 2 Birthdate
Student 2 Birthdate
This could include food allergies, physical/mental challenges, learning disabilities, first time away from home, custody arrangements, etc.
If your child wants to be grouped with a friend, we will do our best. The other child must be in the same grade, and we can only accommodate one friend request per person.
Student 3 Name
Student 3 Name
Student 3 Birthdate
Student 3 Birthdate
This could include food allergies, physical/mental challenges, learning disabilities, first time away from home, custody arrangements, etc.
If your child wants to be grouped with a friend, we will do our best. The other child must be in the same grade, and we can only accommodate one friend request per person.
If you have more than 3 students you are registering for VBS or Day Camp, please email Becky Cole at vbs@hslckirkland.org to register your additional students.
Registration form & payment reserves your spot. After submitting this form, mail payment (cash or check) to: Holy Spirit Lutheran Church Attn: VBS/Day Camp, 10021 NE 124th Street, Kirkland, WA 98034
Please write your name below
Please write your name below.