Martini Lutheran Vacation Bible School
June 27- July 1, 2022
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Child's First and Last Name *
Grade (in Fall) *
Age (at time of VBS) *
Parent's or Legal Guardian's Name *
Address *
City *
Zip Code *
Primary Phone *
Emergency Contact *
Emergency Contact's Primary Phone Number *
Emergency Contact's Relation to Child *
Secondary Emergency Contact
Secondary Emergency Contact's Primary Phone Number
Secondary Emergency's Contact's Relation to Child
Allergies or other information to know
By attending this public event, you agree that: Martini Lutheran has permission to use my child's picture in Martini's VBS movies, media, and other publications and I expect no compensation for the use. Yes, I also give my permission for the Martini staff and volunteers to administer first aid to my child (named above) in the event of an injury or emergency. I understand that 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 Martini's staff or volunteers liable for doing their best effort aid for my child (named above) in the event of injury or emergency. *
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