2017 Tanque Verde Lutheran Church VBS June 19th-23rd, 2017 8:30 – 11:45 a.m
VBS is a weeklong adventure for children in our community. Activities are broken into 4 sections based on age and grade: Team Supers for 3-5 year olds, Team Heros grades K-3, and our Pre-teen Guardians grades 4 and 5.

Registration Deadline: June 11, 2017

Your child will be registered when we receive the Registration Form and your payment.
$30.00 per child, $60.00 for two or more children in family.
Ages: 3 (by December 31, 2016) through 5th grade

Child's Last Name
Your answer
Child's First Name
Your answer
Male or Female
Required
Age
Please enter your child's age as of the start of VBS 6/13/17
Your answer
Date of Birth
MM
/
DD
/
YYYY
School
Your answer
Grade Completed
Your answer
Parent(s) Names
Your answer
Address
Mailing address, City, State, Zip Code
Your answer
E-mail
Your answer
Phone #1
Phone number where you can most likely be reached during VBS
Your answer
Can you receive texts?
Secondary Number
Your answer
Emergency Contact Number
Phone number in case you can not be reached.
Your answer
Home Church
Your answer
Friend Request
Please choose one friend (or sibling) your child would like to be with. We try to accommodate requests.
Your answer
Photo Release
I hereby grant to Tanque Verde Lutheran Church and all representatives and assigns of, the irrevocable and unrestricted right to use and publish photographs of my child/children, or photographs in which he/she/they may be included, for editorial, promotion, publication, advertising and any other purpose and in any manner and medium; to alter the same without restriction; and to copyright the same. I hereby release the Photographer, Tanque Verde Lutheran Church, and all legal representatives and assigns from all claims and liability relating to said photographs.
Required
Allergies/Medical Information
Allergies, medical conditions, medicines currently being taken and other important information: *We will make our best effort to accommodate food allergies, if you would prefer to provide your own snacks please feel free.
Your answer
Hospital Preference
Your answer
Pick-up preference
The following people have my permission to pick up my child
Your answer
People who cannot pick-up my child:
Your answer
General Release
By submitting you agree that you will keep the staff alerted to any changes, permanent or temporary, in my child’s medical condition and to include medications being taken. I understand that Tanque Verde Lutheran Church is not responsible in case of injury or loss of property. I also understand that if medical treatment is required every effort will be made to contact me. However, if I cannot be reached, I give permission to the staff to secure the services of licensed medical personnel for my child and administer emergency medical attention and, if necessary, admit the child to the nearest hospital. I also understand that if it is necessary to dismiss my child during this event for disciplinary reasons, I am responsible to come and pick him/her up immediately or arrange suitable transportation home.
Required
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