St. Peter Evangelical Lutheran Church Galaxy VBS 2026
July 6-10 from 9-11:30am at St. Peter Evangelical Lutheran Church (243 Benedict Ave. Norwalk, OH 419-668-2856) ***Please fill out a new form for each child***
Child's First and Last Name
*
Child's Birthday
*
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Month
-
Day
Year
Date
Grade Completed THIS YEAR
*
Preschool
PreK
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Parent/Guardian Name
*
Relationship to Child
*
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Emergency Contact Name (if parent is unable to be reached)
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Church
Allergies, medical concerns, or special needs?
Photograph Permission
*
I give permission for photographs of my child to be taken and shared on St. Peter Publicity material including, but not limited to: St.Peter’s website, Facebook page and other social media sites St. Peter utilizes. I also give St. Peter to use photographs of my child for brochures or other printed materials that promote the ministries of the St. Peter congregation. I understand that my child’s name will NOT be used on any material. I also understand that St. Peter cannot control how internet photographs might be used by others.
I do NOT give permission for photographs of my child to be used on any St. Peter internet sites or publicity materials.
Signature
*
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Should be Empty: