VBS  Registration 
ALL ARE WELCOME TO COME HAVE FUN AT VBS!
Participants: Children 3yrs-4th grade
Where: Christ the King Lutheran church, Bloomington, MN 
When: June 10th-13th evenings 5pm -8 pm 
Dinner:  provided for participants, their families, and all volunteers 
Cost: $15 due before or on June 10th  
Payment: cash or check payable to Christ the king VBS

Any questions please reach out to 
Kristina Elder -kelder@ctkb.org 
Children, youth and families ministry director 

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Participant (s)
Child attending VBS 
First  Child 
First and last name
*
Child's preferred name *
Child's date of birth  and age  *
last grade attended *
Does your child have any medical needs/history we should know about *
If yes or other to previous question. Please share what you can below. 
I give CTK  permission to use my child's image in videos and brochures. *
Is there anything else you would like to share with us?  If yes please use the space below. 
Second Child
First and last name 
 Child's preferred name 
 Child's birth date and age 
Last grade child attended 
Clear selection
Does your child have any medical needs/history we should know about 
Clear selection
If yes or other to previous question. Please share what you can. 
I give CTK permission to use my child's image in videos and brochures.. 
Clear selection
Is there anything else you would like to share with us? if yes please use the space below. 
Is there anything else you would like to share with us? if yes please use the space below. 
Third Child 
First and last name
Preferred name 
Child's birthdate and age
Child's birthdate and age
Last grade attended 
Clear selection
Does your child have any medical needs/history that we should know abut?
Clear selection
If yes or other was picked on the previous question. Please share what you can. 
I give CTK permission to use my child's image in videos and brochures.
Clear selection
Is there anything else you would like to share with us? if yes please use the space below. 
Parent (s)/ Guardian(s)
Parent/guardian's Names  *
Home address  *
Home address 
Phone numbers *
Phone number
Emergency contact person. Please provide two names and their phone numbers. *
Please list anyone(first and last name) who CAN pick up your child/children  from VBS **Please let them know we may ask to see a photo ID.  In a step to keep your child safe.  *
How did you hear about VBS? *
If you are not a member yet of Christ the king and would like more information about our programs. events and or activities. Or have any questions for us.  Please share your email address.  Thank you *
VBS Volunteers 
YOUTH Volunteers- All those going into 5th grade, along with all middle and high schoolers are welcome to join our VBS team. Adult volunteers- we welcome you to join the VBS team.  Please use this link to sign up.     https://www.signupgenius.com/go/8050F4FAFAF2FA64-49400654-vbsvolunteers
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