Grace Lutheran Church VBS Registration Form
Join us August 6-10, 2018 from 6-8:30pm.

Children, age 3 (potty trained)-rising 6th graders are invited to grow in faith, have fun, and change the world as they practice the stewardship of creation!

Email address *
Child's First Name *
Your answer
Child's Last Name *
Your answer
Parents/Guardians Name(s) *
Your answer
Address (including city and zip code) *
Your answer
Home Phone *
Your answer
Cell Phone *
Your answer
Child's Birthdate *
MM
/
DD
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YYYY
Last School Grade completed *
Home Congregation (if any) *
Your answer
In case of emergency (if parent/guardian)cannot be reached, please contact (name & number) *
Your answer
Emergency contact's relationship to child *
Your answer
Please list ANY allergies (including food or plant) the VBS staff should be aware of *
Your answer
Does your child have any medical conditions the staff should be aware of? *
Your answer
Persons authorized to pick up your child after VBS *
Your answer
My child has permission to participate in all activities. In the event of a medical emergency and, in the event that I cannot be reached, I authorize Grace Lutheran Church’s Vacation Bible School to obtain emergency medical care as may be needed. I grant permission for my child to be included in pictures and give permission for those pictures to be used by Vacation Bible School *
A copy of your responses will be emailed to the address you provided.
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