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 *
Your answer
Grade (September 2019) *
Youth Shirt Size *
Parent/Guardian Name(s) *
Your answer
Mailing Address *
Your answer
Primary Phone Number *
Your answer
Secondary Phone Number
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Person Responsible for Pickup *
Your answer
Person Responsible for Pickup Phone *
Your answer
Allergies or special considerations
Your answer
Church Affiliation (if any)
Your answer
How did you hear about VBS? *
Your answer
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.
Required
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
Required
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