Vacation Bible School Registration

Vacation Bible School Registration

EPIC Australian Adventure - An Unforgettable Journey with Jesus!
Date: Monday June 9th through Friday 13th

Time: 9:00 a.m. - 11:55 a.m.

Where: St. John Lutheran Church, 310 2nd St. E, Newhall

Classes: 3 year-old (as of September 15, 2024) through those just finishing 6th grade

**Please bring a white cotton t-shirt on Monday for Tie Dye Day (no later than Tuesday)
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number*
Format: (000) 000-0000.
Cell Phone Number*
Format: (000) 000-0000.
Work Phone Number
Format: (000) 000-0000.
E-mail*
example@example.com
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Family Doctor Name*
Family Doctor Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Students to register:*

Any allergies or other medical conditions that we need to know about your child(ren)?:
Yes, prior to VBSYes, during VBSNo, thank you

The undersigned herby gives permission for the student(s) registered above to attend St. John Lutheran Church - Vacation Bible School and with this signed agreement, absolves the staff of St. John Lutheran Church, the Vacation Bible School volunteers and any and all members of its governing boards of any responsbility for the safety, welfare, health, and well-being of the child(ren) named above, beyond such matters as may be called reasonable care for child(ren) in the custody of the staff and volunteers and subject to the staff and volunteer's clear instructions, and assumes personally and exclusively all responsbility and liability for any accident, injury, etc., which may occur to the child(ren) named above during hte time of the specific activity as set forth at the beginning of this paragraph.
Type in name as signature:*
Date signed:*

MonthDayYear
Date
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