LUMC VBS Registration 2022
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Email *
Child's Name *
Parent/Guardian Name *
Address *
Email address
Parent or Guardian Phone Number *
Parent or Guardian Secondary Phone Number *
Child's Birthday *
MM
/
DD
/
YYYY
Most recent grade completed *
Required
Home Church (if any)
Friends of child that are attending LUMC Vacation Bible School
Allergies or Special Needs
Emergency Contact Name and Phone Number *
Secondary Emergency Contact Name and Phone Number *
Names of additional adults (other than parent/guardian) that may pick up child from VBS
By checking the box below I give permission for the use of pictures of my child to be used in promotional material associated with this church and this Vacation Bible School. This promotional material may be used as printed promotions, social media, church website, church presentations, etc. I further recognize that no royalty, fee or other compensation shall be payable to me or my child for use of this photo. *
Required
A copy of your responses will be emailed to the address you provided.
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