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VBS on a Stick Registration
August 3-5, 2022
5:30-8:00pm
Supper for families at 5:30pm
Please complete one form for each child participating.
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Participant Name
*
Your answer
Participant Age
*
Your answer
What days will you attend?
*
Wednesday, August 3
Thursday, August 4
Friday, August 5
Required
Dietary restrictions
*
None
Vegetarian
Gluten-free
Required
Other considerations to help provide the best experience (allergies, learning challenges, medications, ect.)
*
Your answer
Parent/Guardian/Grandparent Name
*
Your answer
Will parent/gaurdian/grandparent be eating supper? please chack dates that apply)
Wednesday, August 3
Thursday, August 4
Friday, August 5
Email
*
Your answer
Phone number (s)
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Your answer
Alternate phone number
Your answer
Address
*
Your answer
Alternate answer
Your answer
Emergency Contact
*
Your answer
Emergency Phone Number
*
Your answer
Emergency Address
*
Your answer
Type your name below to signify you agree with the following: I release Christ Lutheran on Capital Hill and supervisors from any liability that may occur at . I also give my permission for my child to participate in all program activities and for Christ on Capitol Hill to use my child's picture promotional use. I give permission for Christ staff to seek emergency medical care for my child.
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Your answer
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