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We look forward to seeing your child(ren) at
Vacation Bible School!

It will be held June 25-29, 2018 from 9:00 a.m.-12 p.m. 

To register your child(ren) for VBS, please fill out the form below. Thank you!

Parent/Guardian's Name *
Parent/Guardian's Name
Parent/Guardian Home Phone *
Parent/Guardian Home Phone
Parent/Guardian Cell Phone *
Parent/Guardian Cell Phone
Must be completed even if home/cell numbers are the same.
Parent Guardian Home Address *
Parent Guardian Home Address
Please complete all fields of home address. For Country, type USA.
2nd Parent/Guardian Name
2nd Parent/Guardian Name
2nd Parent/Guardian Cell Phone
2nd Parent/Guardian Cell Phone
Child's Name *
Child's Name
Child's Birthdate
Child's Birthdate
Please enter any allergies or special needs that your child may have. If none, type NONE.
2nd Child's Name
2nd Child's Name
If you are registering a second child, please fill out all fields related to the second child.
2nd Child's Birthdate
2nd Child's Birthdate
Please enter any allergies or special needs that your child may have. If none, type NONE.
Photo/Video Release *
Throughout the week of VBS, photographs and/or video will be taken and possibly used for publications related to Reformation Lutheran Church such as church bulletins, newsletters, presentations and website. As a Parent/Guardian, I give permissions to Reformation Lutheran Church to photograph and/or record my child/children while they are attending the 2018 VBS program at Reformation Lutheran Church.
Medical Release *
As a parent/guardian, I authorize the treatment by a qualified doctor of the minor(s) listed in the event of an medical emergency while attending the 2018 VBS program at Reformation Lutheran Church
Can You Help With VBS?
YES, I would love to help with VBS! Please check any of the following areas where you can use your gifts for VBS!
Final Authorization *
By selecting I DO agree below, I attest that I am the parent/guardian for the child(ren) listed and all information provide above has been answered fully and correctly.