Vacation Bible School Registration

Ages 3 years to entering 8th grade for school year 2015-2016

Suggested free will offering $10.00 per child

We ask that you please fill out completely one form for each child for ease of registration and for quick access in an emergency.

Child's name *
First Name
Middle
Last Name
Age or grade in fall *
Birthday*
Age*
Allergies or medical concerns*

Father / Guardian

Name
First Name
Middle
Last Name
Email
Address
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Home Phone
Cell phone
Who has Permission to pick up child
Church affiliation
Church membership at
Are you looking for a new Church to attend?
VBS leaders have permission to photograph/film the minor designated above for class photos, bulletin boards and website*

Mother / Guardian

Name
First Name
Middle
Last Name
Email
Address
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Home Phone
Cell Phone

Please make sure that all applicable fields are filled in as completely as possible.

 When clicking the submit button below you are stating that you are a parent or guardian for the above child and are giving permission for the child to be enrolled into the Vacation Bible School at Trinity Lutheran Church.  I also have read the following statements.

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.

I understand that the information I give for this registration will only be used by the VBS hosting church.