2021 Salem VBS Student Registration:                                  August 2-5 / Monday-Thursday / 9am-Noon / Free and open for ages 3 yrs(potty trained) through 5th grade (as of the 2021-2022 school year)
Salem Lutheran Church & School
9615 Pioneer Trail, Greenfield, MN  

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Email *
Name of Parent(s) First & Last Names *
Street address (Please include city, state & zip code) *
Parent's email address *
Phone # *
Emergency Contact (first & last name) *
Emergency Contact's phone number *
Emergency Contact's relationship to your family *
Medical Release (for all of your children attending Vacation Bible School): I give my permission for the VBS staff to administer basic first aid to my child(ren) 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 will be paid by me. *
Print Media Release (for all of your children attending Vacation Bible School): Salem uses photographs in various print media such as, but not limited to, newsletters, bulletins, posters, promotional materials, bulletin board displays, and class projects.  This media use allows Salem to share the events of our church with a wider audience. Please be advised that your child may be included in various photography items at Sunday School and/or Church events. Your child’s name or personal information will not be included.   *
Media (website/social media) Release: (for all of your children attending Vacation Bible School) Photography and videos made by Salem may appear on, but are not limited to, public website and social media outlets managed by Salem.  This media use allows Salem to share the events of our church with a wider audience. Your child’s name or personal information will not be included. *
I do hereby grant Salem Lutheran Church of Greenfield, MN has my permission as indicated in the previous Media Release questions to use and reproduce any and all photographs and videos.  I hereby waive any and all claims to said photography, recordings, and testimonials, as well as any compensations for their use.   *
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