Miraculous Mission VBS registration
August 26-29, 2019
9am - noon
St. Martin Lutheran Church
813 Bay Rd. Webster, NY 14580
Contact us: 585-671-1899 (church office) or Sharon Haffen 585-703-1441
Hosted by: Bethlehem, St. Martin, and Transfiguration Lutheran Churches
Email address *
Child's Name *
Grade (September 2019) *
Youth Shirt Size (T-shirt deadline is August 12) *
Parent/Guardian Name(s) *
Mailing Address *
Primary Phone Number *
Secondary Phone Number
Emergency Contact Name *
Emergency Contact Phone *
Person Responsible for Pickup *
Person Responsible for Pickup Phone *
Allergies or special considerations
Church Affiliation (if any)
How did you hear about VBS? *
Medical Release *
It is my understanding that the church will attempt to notify me in case of a medical emergency involving my child. If the church cannot reach me, then I authorize the church to seek medical care for my child and I give my permission for medical services that may be deemed necessary. I will pay for any medical expenses so incurred. I will notify the church if there are any health considerations that would prevent my child from participating in any activities. I hereby do release St. Martin Lutheran Church, Bethlehem Lutheran Church, and Transfiguration Lutheran Church from all manners of actions, claims, which I or the child named above shall or may have for any reason arising during my child's attendance of VBS.
Media Release *
I understand any pictures taken at VBS may be used in print or digital media to advertise our church’s programs. Please contact the church if you would prefer images of your child not be used for these purposes
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