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Registracion del Participante

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Prince of Peace Lutheran Church

Location

8304 Old Keene Mill Rd

Springfield, VA 22152-1640

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Contact Alex Lillis:

703-451-5855

alex.lillis@poplc.org

Primero, cuéntenos sobre usted:

Información de los Padres

Nombre

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Apellido

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Correo Electrónico

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Would you like to be on the email list for Prince of Peace Children's Ministry Events throughout the school year?

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(optional)

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Would Parent/Guardian #2 like to be on the email list for Prince of Peace Children's Ministry Events throughout the school year?

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Teléfono de Contacto 1

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Teléfono de Contacto 2

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Dirección 1

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Dirección 2

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Ciudad

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Estado/Provincia

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ZIP/Código Postal

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País

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Afiliación de la iglesia local

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Nombre del Contacto de Emergencia

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Relación del Contacto de Emergencia

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Teléfono del Contacto de Emergencia

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Emergency contact email

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Comentarios

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Click here for your FREE Friends With God Kids Activity Pack

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Cuéntanos sobre tu participante

Which session will they be attending?

Nombre

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Apellido

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Please select the Grade your child will be entering in the Fall of 2026.

Vacation Bible School participant spots are open to children entering Grades 1-6 in the Fall of 2026. Children younger than this are invited to register for our POP School Camp, and children older than this are invited to register as a VBS volunteer.

Grado Entrando

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Género

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Fecha de nacimiento

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Talla de Camisa

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Alergias

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Preocupaciones Médicas

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Has this child been baptized?

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Does Prince of Peace have your permission to use your child(ren)'s photograph in any of its publications, including both printed and digital?

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¿Tienes amigos con los que te gustaría estar juntos? Haremos todo lo posible para juntar a los amigos seleccionados en el mismo grupo, pero no podemos prometer que todas las solicitudes serán posibles.

Amigo 1 Nombre

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Amigo 1 Apellido

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Amigo 2 Nombre

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Amigo 2 Apellido

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Amigo 3 Nombre

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Amigo 3 Apellido

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Comentarios

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