Jesus: Powerful Savior - VBS 2019
June 17-20, 2019
9am-Noon
Messiah Lutheran Church,
1308 Whitley Rd.
Keller, TX
Email address *
Child's First Name *
Your answer
Child's Last Name *
Your answer
Nickname
Your answer
Grade entering this Fall (K-5th)? *
Your answer
Gender *
Home Church (If applicable)
Your answer
How did you hear about our VBS?
Your answer
Allergies
Your answer
Special Medical Needs
Your answer
Medical Release *
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.
Required
Photo Release *
I hereby grant Messiah Lutheran Church permission to copyright and use photographs/videos taken at VBS of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.
Required
Parent Last Name *
Your answer
Parent First Name *
Your answer
Address 1 *
Your answer
Address 2
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Email *
(we will not share or sell your email address)
Your answer
Primary Phone Number *
Your answer
Other Phone Number
Your answer
Emergency Contact *
First and Last Name
Your answer
Emergency Contact Phone *
Your answer
Alternate Pickup
First and Last Name
Your answer
Alternate Pickup Phone
Your answer
General Information
Your answer
Permission to Attend *
I give permission for my child (named above) to attend Vacation Bible School at Messiah Lutheran Church as listed above. I understand that the information I give for this registration will only be used by Messiah Lutheran Church.
Required
How did you hear about our VBS?
Your answer
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