Christ Lutheran Church 2026 Vacation Bible School Registration Form

Christ Lutheran Church 2026 Vacation Bible School Registration Form

July 27-30, 2026, 9:30-11:45 AM, for kids age 4 (potty-trained) to kids entering 6th grade. Please fill out the child's and parent/guardian's details to complete the registration.
Child's Name

First NameLast Name
Child's Date of Birth

MonthDayYear
Date
Child's Age
Child's Last School Grade Completed
Parent/Family/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Email Address
example@example.com
Primary Parent/Caregiver Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Secondary Parent/Caregiver Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Name(s) of person(s) who may pick up this child from VBS
Home church (if any)
Friends of your child at this church (if any)
Does the child have any special needs/allergies/medical information that we should be aware of? Please give details.
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Photo Release: Christ Lutheran Church/VBS has my permission to use my child's photograph publicly in Christ Lutheran VBS materials. I understand the images may be used in print, online, websites and social media. I also understand that no royalty, fee, or other compensation shall become payable to me by reason of such use. (Type parent/guardian initials.)
Should be Empty: