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Hallelujah Party
Saturday, October 31st - 6-8 P.M.
Bushkill Fire House
Ages 3 to 5th Grade
Child Information
First Name:
Last Name:
Age:
Grade:
Parents Information
Mother's First Name:
Mother's Last Name:
Father's First Name:
Father's Last Name:
Address And Contact Information
Street Address:
City:
State:
Zip:
Email:
Home Phone:
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-
Work Phone:
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-
Cell Phone:
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Pick Up Information
If someone other than the parents will be picking up the child after VBS, please give us their name.
Pick-up Person's First Name:
Pick-up Person's Last Name:
Medical/Allergy Information
Are there any allergies (such as specific foods or bee stings) or medical conditions that we should be aware of? (please explain)
Cost: 1 bag of candy per child
No SCARY costumes allowed
Call 588-6998 for more info
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