IN PERSON Vacation Bible School                       Messiah Lutheran Church & Preschool TAMPA, FL Breaker Rock Beach VBS 2024 Registration
JUNE 3-7, 2024
@ Messiah Lutheran Church & Preschool 14920 Hutchison Rd. Tampa, FL 33625
Time: 9AM-Noon

Attendees must be 4 year old preschool age - 6th grade. IN PERSON SPACE WILL BE LIMITED. 
Those in 7th grade+ are invited to apply to volunteer!

Breaker Rock Beach! God's Rock Solid Truth In a World of Shifting Sands! (a LifeWay VBS)

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Parent/Guardian Name *
Address (street address) *
Address (city, state, & zip code) *
Mailing Address (if different)
Phone Numbers
Please provide at least one of the phone number types listed below (more if possible).
Home # (if applicable)
Work # (if applicable)
Cell # (if applicable)
Email *
Child One's Name *
Child Date of Birth *
Grade completed in school during 2023-2024 school year *
Medical Information
Medical or other information we need to know. (Please include any food allergies.)
Emergency Contacts (other than listed above) Names & Phone Numbers *
Dismissal Information
Who may pick up your child at the end of each VBS day?
Other Information
Does your child attend Sunday School? If yes, where?
If your child is visiting our church, who is (s)he a guest of?
May we have permission to photograph your child (typically we use photos for the end of the week closing program slide show and sometimes a craft)? *
May we have permission to use your child's photograph for the purpose of promotion or recap including on social media or livestream worship? *
I (sign name) understand that my minor child(ren) is /are ONLY to come to this program if they are in good health (no cough or fever in the last 48 hours) and no known COVID exposure. I give consent for them to participate in this activity. *
I understand that my minor child(ren) is /are ONLY to come to this program if they are in good health (no cough, fever, vomit, diarreha, rash, lice, or infection in the last 48 hours) and no known COVID exposure. I give consent for them to participate in this activity. *
I give consent on... *
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/
DD
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This is my only eligible to attend Child *
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