Clone of 2025 VBS Registration

2026 VBS Registration Form

Fill out the form carefully for registration
June 22nd thru June 26th

9am til 11:30am

For ages 4 thru 12

Pre-school thru 6th Grade
Child Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Ages 4 (must be potty trained) - 12
Last Grade Completed (Kindergarten mark 0)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Allergies and/or Medial Conditions
Home Church
Parental/Guardian Info
Parent/Guardian 1

First NameLast Name
Parent/Guardian 2

First NameLast Name
Parent/Guardian E-mail
example@example.com
Parent/Guardian Mobile Number
Format: (000) 000-0000.
Home Phone Number
Format: (000) 000-0000.
Work Number
Format: (000) 000-0000.
Emergency Contact

First NameLast Name
Emergency Contact Number
Format: (000) 000-0000.
Pickup Info

To by Verified at every pickup
Primary Pickup Name

First NameLast Name
Primary Pickup Contact Number
Format: (000) 000-0000.
Secondary Pickup Name

First NameLast Name
Secondary Pickup Contact Number
Format: (000) 000-0000.
I give my consent that my child may appear in photography or videos while participating in the VBS experience at Hope Lutheran Church. I understand that these pictures and/or videos remain the property of Hope Lutheran Church.
Signature
Should be Empty:

2026 VBS Registration Form