Secured Registration Hosted by: Ackerman Music Studio 2023 Trinity Lutheran VBS Registration VBS Registration Child's First Name * Child's Last Name * Child's Age * 4 5 6 7 8 9 10 11 Grade Completed Pre-K Kindergarten 1st 2nd 3rd 4th 5th Parent's First Name * Parent's Last Name * Street Address * City * State * Zip Code * Mom's Phone Number * Dad's Phone Number * Paren'ts email * Confirm email * Allergies * This is a required field, but if your child does not have any allergies please just enter "None." Medical/Special Needs* * This is a required field, but if your child does not have any medical/special needs please just enter "None." Family Doctor * This is a required field, but if your child does not have a Family Doctor please just enter "None." Doctor's Phone number * This is a required field, but if your child does not have a Family Doctor please just enter "None." Emergency Contact (NOT a parent) * In case we can not reach you in an emergency, whom would you like us to contact? Emergency Contact's Relationship to the child * Sibling Grandparent Aunt Uncle Cousin Family Friend Emergency Contact's Phone Number * Siblings Attending VBS (list names) * * This is a required field, but if your child has no siblings attending VBS please just enter "None". Home Church (if applicable) * This is a required field, but if you and your family do not have a home church, please enter "None". Medical Release * I give my permission for the VBS staff to administer basic first aid to my child 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 services will be paid by me. Photo/Video Release * Yes No I give VBS leaders permission to photograph/film my child (designated above) in any manner or form for any lawful purpose. If you are human, leave this field blank. Submit Start Over Δ Share this:TwitterFacebookLike this:Like Loading...
