OUR LADY OF PEACE VACATION BIBLE SCHOOL 2011

For Children Pre-K to Entering 4th Grade

Monday, June 27 through Friday, July 1, 2011

9:00 a.m. to 12:00 noon
Cost: $35 per child $90 family maximum
Please complete the information below and return with payment to OLP Rectory,
111 South Street, New Providence, NJ 07974. Make checks payable to OLP Church

Child’s Name (first and last) Age Grade Completed

_____________________________ _______ ____________________
_____________________________ _______ ____________________
_____________________________ _______ ____________________

Parent Contact Information

Parent/Guardian Name(s): ____________________________________
Mailing Address: ______________________________________________
E-Mail Address:_______________________________________________
Home Phone: __________________ Cell: ___________________________
Emergency Contact: (Name) _____________ (Phone) __________________

Adult and Student (MS/HS) Volunteers Needed:

Dates Available: (circle) Mon. 6/27 Tue. 6/28 Wed. 6/29 Thur. 6/30 Fri. 7/1
Name: (circle) Parent or Student: _________________________________
E-Mail Address:_______________________________________________
Home Phone: ______________________ Cell: _______________________