Registration Form Child's Name(required) Address Age(required) Grade just completed(required) Name of Siblings Attending VBS Mother's Name Mother's Phone Number Mother's Email Father's Name Father's Phone Number Father's Email Emergency Contact Relationship to child Best Phone for Emergency Contact Food Allergies Medical Allergies or Conditions People who may pick up the child I permit my child’s name and food allergy to be posted for VBS staff to see. Choose one(required) Yes No N/A VBS leaders have permission to photograph/film the minor designated above in any manner or form for any lawful purpose associated with this VBS program. Choose one(required) Yes No By submitting this form, I agree that my child has my permission to attend and participate in the Zoomerang VBS program, July 18-22, 2022. Send Δ Share this:TwitterFacebookLike this:Like Loading...
Immanuel Evangelical Lutheran Church