ROAR!!! Vacation Bible School REGISTRATION
(Remember, all attendees MUST be POTTY-TRAINED!!!)
Student's First Name *
Your answer
Street Address *
Your answer
City, State, & Zip *
Your answer
Cellphone number *
Your answer
Age *
Date of Birth (mm/dd/yyyy) *
MM
/
DD
/
YYYY
Gender *
Email Address *
Your answer
Grade in School as of April 2019 *
School Attending
Your answer
T-shirt size *
Please indicate any special needs your child has, such as medications, allergies, or learning disabilities (you may also type 'none'). *
Your answer
Baptized? *
Required
Family Church
Your answer
Father's Name
Your answer
Father's Mobile Phone
Your answer
Father's Email
Your answer
Father's Address (if different from student)
Your answer
Mother's Name
Your answer
Mother's Mobile Phone
Your answer
Mother's Email
Your answer
Mother's Address (if different from student)
Your answer
Emergency Contact / Phone # *
Your answer
Would you like to volunteer to help with Vacation Bible School? *
If so, name and contact information:
Your answer
Permission to Photograph: Trinity Lutheran Church will, on occasion, take photographs for use on our website or social media platforms. We need your permission to publish a photograph or image of your child(ren) in any church-sponsored publication, including but not limited to church brochures, video recordings, church newsletters, and the church website as well as newspapers, television promotions, and/or the Internet. This permission is valid for the 2019 Vacation Bible School only. I may revoke this permission at any time by notifying in writing the Director of Children's Ministries. *
Any other information we should know pertaining to your child:
Your answer
The following people are AUTHORIZED to pick-up my child (children) from Vacation Bible School. (Please include the person's first and last name, relationship to the child, and cell phone number.) *
Your answer
Signature (please type your first and last name in the box below): *
Your answer
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