Mission Liberty Hill Lutheran Church VBS
**Please fill out a form for each participant that plans to attend VBS!  
We will be having a light meal from 5:00-5:30 pm and VBS from 5:30-7:30 pm.
Email kidmin@missionlibertyhill.com with questions!
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VBS Participant First Name *
VBS Participant Last Name *
VBS Participant Mailing Address (please include street address as well as city and zip code) *
VBS Participant Grade Completed 2023-2024 School Year *
Days your child will be able to attend... *
Required
What days will your family be joining us for a light meal? (If filling out multiple forms, please only answer this question on one child's form) *
Required
Approximately how many people can we plan for from your family joining us for our light meal?  (If filling out multiple forms, please only answer this question on one child's form) *
Contact email address *
Contact Cell Phone Number *
May we contact you by text ONLY regarding updates and information? *
Does your child have any allergies we should be aware of?  Please explain. *
Emergency Contact #1 Name (First/Last Name) *
Emergency Contact #1 Relation to Child *
Emergency Contact #1 Phone Number *
Emergency Contact #2 Name (First/Last Name) *
Emergency Contact #2 Relation to Child *
Emergency Contact #2 Phone Number *
Home Church *
Photo Release: We will be taking photographs of various activities and events during VBS. These photos may be displayed on the church website, Facebook page, monthly newsletter, bulletin board, and local synodical newspaper. We will not publicize photos without your consent. Please select your preference. *
My child has permission to participate in Mission Liberty Hill Lutheran Church Vacation Bible School 2024. In the event of a medical emergency when I, the parent or legal guardian, cannot be reached, I hereby authorize the director or designated adult counselor of MLHLC to secure the necessary medical or dental treatment at any hospital, clinic, or doctor’s office. I also agree that in no way will the church, pastor, VBS director, or VBS counselor be held liable for actions taken in an emergency situation. *
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