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Participant Registration

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Registro en Español

OLPH-Selma, Texas

Location

16075 N Evans Rd

Selma, TX 78154

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Contact Maria Sanchez:

(210) 651-6913 ext. 120

msanchez@olph.org

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Address 1

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Address 2

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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Text Message Phone Number If Different from Above

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Parent Information 2

First Name

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Last Name

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Contact Phone 2

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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My child attends the OLPH Child Development Center (CDC) and will be dropped off and picked up by them during VBS week..

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Alternate Pickup Name

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Alternate Pickup Phone

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Alternate Pickup 2 Name

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Alternate Pickup 2 Phone

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Grade Entering

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Gender

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Date Of Birth

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Shirt Size

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PHOTO/VIDEO RELEASE PERMISSION- Used in Church Promotion/Website/PowerPoint

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Allergies

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Medical Concerns

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew or traveling pod, but we cannot promise all requests will be possible.

Participants are usually grouped with the following grade levels:

Kinder & 1st -

2nd & 3rd -

4th & 5th

Friend 1 First Name

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Friend 1 Last Name

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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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Comments

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