Christ Lutheran Vacation Bible School Registration
One form per child, please!

Miraculous Mission VBS is July 8-11, 2019 --- 9:00 - 11:45am
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Student First Name *
Nickname?
Student Last Name *
Age *
Gender
Clear selection
Grade entering in fall? *
What School Will They Be Attending?
Home Church (if applicable)
Allergies
Medical Issues or Special Needs
It would be nice if my child is placed in same group as (child's name)
Parent Name *
Address *
City *
State *
Zip Code *
Home Phone Number *
Cell Phone Number
Other Phone Number
Email *
Emergency Contact
Emergency Phone
Alternate Pickup Name
Alternate Pickup Phone
Other Information?
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.
Required
Photo Release *
I grant Christ Lutheran permission to copyright and use photographs/videos taken at VBS of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.
Required
Permission to Attend *
I give permission for my child (named above) to attend the Vacation Bible School (VBS) listed above. I understand that the information I give for this registration will only be used by the VBS hosting church, and that all registration information will be removed from the hosting site by December 31 of this year.
Required
Parents e-Signature *
Submit
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