Mount Cross 2026 VBS Compassion Camp Registration & Medical Form

Vacation Bible School Registration Form

August 3rd-7th, 2026/9:00 A.M - 12:00 P.M. Each Day
Welcome to Vacation Bible School 2026 at Mount Cross Lutheran Church! Our theme this year is Compassion Camp. We invite you to sign your child/children up for a week of fun filled games, crafts, music, snacks, and Bible stories. Kids aged 4-11 are welcome to participate.

Payment Forms

Registration can be paid via credit card. However, if you would prefer to pay via cash or check, or are in need of financial support, please email Pastor Marc Mohr (vbs@mountcross.com).

After the registration form is complete, you will receive a confirmation email.

Camp Information

For Vacation Bible School general information: https://www.mountcross.com/vacation-bible-school.html

As mentioned, for all questions please contact Pastor Marc Mohr (vbs@mountcross.com) or call the church office (805) 482-3847. We hope you are able to join us!
Child Registration

Please fill out the form as accurate as possible.
Child #1 First & Last Name

First NameLast Name
Child #1 - Grade Entering Into
Child #1 Age

MonthDayYear
Date
Child #1 T-shirt Size
Child #1 Gender
Child #2 First & Last Name

First NameLast Name
Child #2 - Grade Entering Into
Child #2 Age

MonthDayYear
Date
Child #2 T-shirt Size
Child #2 Gender
Child #3 First & Last Name

First NameLast Name
Child #3 - Grade Entering Into
Child #3 Age

MonthDayYear
Date
Child #3 T-shirt Size
Child #3 Gender
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Email Address
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Parent/Guardian Full Name

First NameLast Name
Secondary Parent/Guardian Email Address
example@example.com
Secondary Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Full Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are there any allergies, medical conditions, or dietary restrictions?
Medical Release Form

For all children & youth events affiliated with Mount Cross Lutheran Church.
Physician Information:

Name of Physician

Physician Address

CityState / Province

Postal / Zip Code
Medical Insurance Information:

Name of Insurance Company

Member Number (If more than one child, put all that apply)

CityState / Province

Group Number
Does your child have any allergies?
If yes, please specify allergies.
*Medical Authorization* I hereby give permission to authorized representatives of Mount Cross Lutheran Church to authorize necessary emergency medical consultation, examination and treatment of the above named child or children, including the prescription of needed medications, in the event of accident, illness or other trauma at any medical facility
What medicine do you not want to be administered?
*Media Authorization* I hereby grant permission for Mount Cross Lutheran Church to record pictures or videos of my child or children while on the church property or at a church-sponsored event. I also give permission for Mount Cross Lutheran Church to use these images or videos in church print and online publications.
Signature

VBS Registration Cost

Individual Registration

1 child

$69.00 Quantity

2 Child Registration

2 children

$129.00 Quantity

3+ Child Registration

3 or more children

$159.00 Quantity

Enter coupon

Total

Credit Card

Should be Empty:

Vacation Bible School Registration Form

Child Registration

Medical Release Form

VBS Registration Cost*

Credit Card

VBS Registration Cost