Concordia's VBS 2023
God's Living Water June 12-16 9am-11:30am
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Child's First and Last Name *
Grade In Fall *
Age at time of VBS
Parent or Legal Guardian's Name *
Address including City and Zip *
Primary Phone *
Best way to contact on Primary Phone *
Required
Email
We use this to send links to videos on our Youtube Channel. If we make VBS videos (program or pictures) they are set to unlisted. In order to view these videos, you will need the link sent in the email. 
Emergency Contact's Name *
Emergency Contact's Phone Number *
Emergency Contact's Relation to Child *
If you would like a secondary emergency contact, please list the name, phone number, and relation to the child below.
Allergies or other information to know:
Food allergies, needs help in bathroom, etc.
Church Membership
Does your child know someone else going to VBS that they want to be in the same class with?
Example of our class breakdown: PreK and under; Kindergarten; 1st-2nd; 3rd-4th; and 5th-6th
By attending this public event, you agree that: Concordia has permission to use my child's picture in Concordia's VBS movies, media, and other publications and I expect no compensation for the use. Yes, I also give my permission for the Concordia staff and volunteers to administer first aid to my child (named above) in the event of an injury or emergency. I understand the VBS staff will contact emergency services in the event of a significant injury and all expenses for emergency services will be paid by me. I will also not hold Concordia's staff or volunteers liable for doing their best effort aid my child (named above) in the event of injury or emergency.
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