2022 Vacation Bible School Registration

"Epic Tales" - June 13-17 | 9am-noon

It's going to be Epic fun learning about God’s love for all people through our favorite Bible stories. Children must be 4 years of age by June 1, 2022 to register.
Child Information
Child's Name: *

First Name Last Name
Birth Date: *

Month Day Year
Age: *
Gender: *
Grade Completed: *
Special Needs / Allergies / Concerns:

Parent/Guardian Information
Parent/Gardian: *

First Name Last Name
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Preferred Phone: *
Alternate Phone:
E-mail: *
example@example.com
Emergency Contact Information
Emergency Contact: *

First Name Last Name
Emergency Contact Phone: *
Who is authorized to pick up Child: *

Participation Consent
Parental Consent and Release
- I understand there may be elements of risk associated with activities at Abiding Presence Lutheran Church’s Vacation Bible School. I hereby release and agree to indemnify and hold harmless Abiding Presence Lutheran Church from any and all claims of any nature, whether such claim is caused by an APLC employee, APLC volunteer, any other VBS participant or my child, during my child's participation at Abiding Presence Lutheran Church's Vacation Bible School.
- In case of an emergency, I give permission for my child to be administered medical aid by church medical volunteers. I give Abiding Presence Lutheran Church, its staff and volunteers, the authority to call EMS, to transport, or to obtain medical care if the parents/guardians or the alternate emergency contact person cannot be reached. Abiding Presence Lutheran Church does not assume any financial responsibility incurred for the emergency care of my child.
- I understand that photographs and video footage taken of my child as a result of participation in activities at Abiding Presence Lutheran Church may be used in Abiding Presence Lutheran Church’s printed materials, website, and social media.
Child's Name of Consent: *

First Name Last Name
Parent's Name: *

First Name Last Name
Date:

Month Day Year
Date
Hour Minutes AM/PM Option
By submitting this form, I give permission for my child to participate in all activities at Abiding Presence Lutheran Church’s Vacation Bible School and agree to all terms of Parental Consent and Release. Submission of this form constitutes my legal signature.
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"Epic Tales" - June 13-17 | 9am-noon

Child Information

Parent/Guardian Information

Emergency Contact Information

Participation Consent