2019 VBS REGISTRATION

JUNE 17 - 20th; 9 a.m. - noon

Child's Name *
Child's Name
Child's Birthday *
Child's Birthday
1st Parent/Guardian Name *
1st Parent/Guardian Name
1st Parent/Guardian Phone Number *
1st Parent/Guardian Phone Number
2nd Parent/Guardian Name (optional)
2nd Parent/Guardian Name (optional)
2nd Parent/Guardian Phone Number (optional)
2nd Parent/Guardian Phone Number (optional)
Address *
Address
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone Number *
Emergency Contact Phone Number
Would you like to volunteer to help at VBS? *
Medical Release *
I understand Bethany Lutheran Church and School will make every effort to contact me, or those named, in case of an emergency requiring a physician. However, if unable to make contact, the Church leaders are hereby authorized to take whatever action deemed necessary in their judgment for the health of my child. I also understand the Church has no financial responsibility for emergency care for my child or transportation in an emergency vehicle should the need arise.
Permission to Photograph *
I grant Bethany Lutheran Church and School permission to use photographs of my child in publications (newsletters, weekly emails, worship bulletins, inserts, slideshows, etc.), including website entries.
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Check out these great pictures from last year’s VBS!