Vacation Bible School Registration 2019 June 10-14; 9am-11:30am
Concordia Lutheran Church's 2019 VBS Miraculous Mission
One form per child is needed
Child's First and Last Name *
Your answer
Grade (in fall) *
Age *
Your answer
Parent's or Legal Guardian's Name(s) *
Your answer
Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Family's Church
Your answer
Emergency Contact's Name *
Your answer
Emergency Contact's Relation to Student *
Your answer
Emergency Contact's Phone *
Who are we calling in case of emergency?
Your answer
Secondary Phone
In case of Emergency this will be the SECOND number we call in case of emergency.
Your answer
Food Allergies or other useful information we need to know:
Your answer
Do we have photo permission? *
We make a powerpoint for VBS that we send to families after VBS, use pictures in our newsletter, and may use them on our website, or other publications. The question we have, may we use your child's photo?
Medical Permission *
I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me. I will also not hold any of Concordia's staff or volunteers liable for trying to aid my child (named above) in the event of injury or emergency.
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