2023 VBS REGISTRATION FORM

VBS REGISTRATION FORM
Child's Name
Street address
City
State
ZIP
Telephone
Parent e mail address
example@example.com
Date of birth

MonthDayYear
Date
Grade
T-Shirt Size (check one)

Child SmallChild MediumChild LargeAdult SmallAdult MediumAdult LargeAdult XLAdult XXL
In case of emergency, contact (name)
In case of emergency, contact (phone)
Parent/Guardian Name(s)
Allergies or other medical conditions
Name of a special friend your child might like to be with
I give permission for my child to take part in the activities provided by Redeemer Lutheran Church and for the information provided above to be held and used by the Christian Ed. Team.

YesNo
I give permission for Redeemer Lutheran Church to use photo/video footage taken during the activities for promotional purposes such as displays, Alden Advance and presentations of our work.

YesNo
I understand that Redeemer Lutheran Church cannot take responsibility if my child does not follow leader rules/direction during the activity.

YesNo
Dated

MonthDayYear
Date
Signature

Clear
Full Name
Relationship
Registration Fee: $20.00 per child (includes t-shirt) Please make checks payable to Redeemer Lutheran Church *Please note if cost is a factor, please contact the Church Office as scholarships are available. We want all children to have the opportunity to attend*
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