The Greatest Story VBS Registration Form
Fill out one registration form per family.
June 30-July 3, 5-8:30 p.m.. We will begin with a FREE dinner, then as kids head out with their group leaders, grown-ups are invited to stay and take part in meaningful learning and formation activities and classes.
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Parents/Guardian Last Name
Parents/Guardian First Name *
Parents/Guardian Email Address *
Parents/Guardian Physical Address (Street, City, State, Zip) *
Parents/Guardian Phone Number *
Emergency Contacts (Name, Phone Number/s) *
Please list any and all emergency contacts and phone numbers.
Dismissal Information *
Please list name(s) of person(s) who may pick up this child from VBS. 
Is your family members of Gloria Dei Lutheran Church? (Don't worry. You don't have to be.) *
Required
Health Insurance Information
While every effort is made to ensure the safety of each and every child while attending our programs, accidents do happen. Please supply your child's health insurance information in the event of any emergency.
Policy Holder's Name *
Insurance Company Name *
Policy/Member Number *
Primary Physician's Name and Phone Number *
Dentist's Name and Phone Number (if applicable)
Release from Liability (initials/date) *
By my initials below, I consent to any ex-ray, examination, anesthetic, medical, dental, or surgical diagnosis or treatment and hospital care under the general supervision and upon the advice of or to be rendered by a physician, surgeon, and dentist licensed under the Medical Practice Act and Dental Practice Act. As parent or legal guardian, I am responsible for the health care decisions of my child and am authorized to consent to services to be rendered, and no other consent is required by law. I hereby give permission to the physician selected by the activities supervisory personnel then present to render medical treatment deemed necessary and appropriate by the physician or dentist. I will assume FULL FINANCIAL RESPONSIBILITY for care given.

I warrant and represent that I am eighteen years of age or older and am fuller aware of and understand the terms and legal consequences of the signing of this form. I intend my signature to be a compete and unconditional release of all liability to the greatest extent allowed by law.
K-5th Grade Covenant
Grown-ups of K-5th graders, please review the following with your child:

As a participant in VBS, and as a child of God, I understand and agree to the following expectations...
  • I will choose to participate fully in Vacation Bible School.
  • I will choose to respect all people, including myself, choosing to treat others as I would like to be treated.
  • I will choose to listen to all leaders and volunteers.
  • I will choose to use my words to build others up, or I will choose to be quiet.
  • I will not bring harm to myself or others. I will choose to maintain self-control.
  • I will choose to be respectful of the facilities and grounds where VBS is held. I understand that if I damage another's property, I am responsible for replacing/repairing it.
Covenant Signature - child (Initials/Date) *
I understand that if I choose to break this covenant, there are consequences. I will take responsibility for my actions. I understand that if I choose to harm myself or others, my parent/guardian will be contacted and I will be sent home.
Covenant Signature - parent/guardian (Initials/Date) *
I have read this covenant and enter into it with my child. I will encourage my child to abide by it daily. I understand that should my child choose to break this covenant, every effort will be made to contact me and my child will be sent home. I also understand that if I am not reachable, an emergency contact listed will be contacted.
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