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Shipwrecked VBS Participant Registration
Please complete one form per child. VBS is June 17-21 from 6pm-8:15pm. There is a $15 suggested payment per child. If registering online, you can pay on the first day of VBS at the registration table. Please fill out the form below and we look forward to seeing you on June 17th! Scholarship money is available to families who need help paying for VBS. Please speak to Amy Schutte for assistance or call at 651-457-3929 X111.
Email address *
Child's First and Last Name *
Your answer
Grade Entering Next Year *
Your answer
Date of birth *
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YYYY
Parent's Name *
Your answer
Street address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Cell Phone Number *
Your answer
Email Address *
Your answer
Allergies or other medical conditions
Your answer
In case of emergency contact name *
Your answer
Emergency contact phone *
Your answer
Emergency contact relationship to child *
Your answer
Individuals authorized to pick up your child (If we do not recognize the person picking up your child, we may ask for an ID)
Your answer
Phot Release: I hereby grant permission for my child listed on this form, to be included in pictures, promotional material, and publications connected with Vacation Bible School at Emanuel Lutheran Church. My child's picture may appear in publications and promotional materials, such as, but not limited to, as follows: Church Newsletter (News and Notes), PowerPoint Presentations, Church's website www.emanuellutheranchurch.org, church brochures, postcard, and flyers. (Please initial below if you give permission).
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