VBS 2024 Registration
June 24th-27th, 2024- 6:00-8:00PM (Doors open at 5:45)
Ages: Current Preschoolers (must be potty trained)- Entering 5th Grade in Fall of 2024

Fill out the form below to register your child for VBS! One form must be filled out for each child attending.
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Email *
Child's First Name *
Child's Last Name *
Child's Date of Birth *
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Child's Address *
Mother's Name and Phone Number *
Father's Name and Phone Number *
Emergency Contact Name and Phone Number *
Home Church Name (N/A if you don't have a church home)
Does your child have any known allergies? If so, please list them below. *
Does your child have any medical issues that we need to be aware of? *
Does your child have any special needs? *
Please list all adults authorized to pick up your child: *
Are you interested in attending the Adult VBS led by Mr. Alex Holcomb? *
Are you interested in volunteering during VBS? *
In case of emergency, I authorize Bethlehem Lutheran Church to seek medical attention for my child. Bethlehem Lutheran Church does not assume any financial responsibility, but will provide or arrange for emergency care. By submitting this form, you are giving the appropriate VBS personnel authority to call EMS, to transport, or to obtain medical care if you or the alternate adults cannot be reached.

Please enter your name as your consent:
 *
I hereby grant Bethlehem Lutheran Church permission to copyright and use still photo, video, and/or audio tape recording of the minor(s) designated above in any manner or form for any lawful purpose at any time.

Enter your name as your consent:
 *
May we contact you in the future about other events at Bethlehem Lutheran Church, School and Preschool? *
A copy of your responses will be emailed to the address you provided.
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