ROAR! Participant Registration Form
Use this form to register for VBS at St Matthew Lutheran Church
Sunday, June 23 - Thursday, June 27 6:15 pm - 8:30 pm
Participant Registration
NOTE: If you are bringing children who are not your own, please fill out a separate form per family.
Participant #1 Name *
Your answer
Participant #1 Gender *
Participant #1 Grade Entering Fall 2019 *
Participant #2 Name
Your answer
Participant #2 Gender
Participant #2 Grade Entering Fall 2019
Participant #3 Name
Your answer
Participant #3 Gender
Participant #3 Grade Entering Fall 2019
Participant #4 Name
Your answer
Participant #4 Gender
Participant #4 Grade Entering Fall 2019
Parent(s)/Guardian(s) (of above participants) *
Your answer
Will adult(s) listed above be participating with their child(ren) at VBS? *
Address and Contact Information
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Preferred Contact (Email and/or phone #) *
Your answer
Travel Plans: The child(ren) listed above will travel to/from VBS with: *
Your answer
Emergency Contact Information
Emergency Contact Name *
Your answer
Emergency Contact relationship to participant(s) *
Your answer
Is Emergency Contact attending VBS? *
If "Yes", select days attending...
Emergency Contact Phone Number *
Phone number where contact may be reached while participant is attending VBS.
Your answer
Placement request, allergies, and photo information
Placement request?
(While we will attempt to honor your request, due to limited space, placement requests are not guaranteed.)
Your answer
Food Allergies or Medical Concerns? *
If Yes, please explain.
Your answer
Photographs will be taken during this VBS event. If you do NOT want photos of you/your child(ren) to appear in St. Matthew publications (newsletter/VBS publicity/power point screens/church website/etc.) please check this box.
A pre-event meal is offered each night of VBS (served at 5:30). Please give us a head count of how many participants in your family group plan to eat the meal each evening. Thanks! (suggested donation, $2 per person, per meal)
Sunday: Subway sandwiches
Monday: Taco "stuff"
Tuesday: Sloppy Joes
Wednesday: Hot dogs
Thursday: Pizza
Sunday dinner headcount *
Your answer
Monday dinner headcount *
Your answer
Tuesday dinner headcount *
Your answer
Wednesday dinner headcount *
Your answer
Thursday dinner headcount *
Your answer
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