VBS 2017 Child/Parent

Child Registration

Please fill out a separate registration for each child you are enrolling for VBS this year. Thank you.

Child's Name

Nickname

Gender

Age of Child

Grade Entering Fall 2017

T-Shirt Size

Child's Medical Information

Allergies:

Medical Issues or Special Needs

I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me. (Accept by clicking below)

Medical Release

Other Information

General Information

I hereby grant the St. Paul Lutheran Church Harlingen Texas church permission to copyright and use photographs/videos taken at VBS of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied. I give permission for my child (named above) to attend the Vacation Bible School at St. Paul Lutheran Church. I understand that the information I give for this registration will only be used by St. Paul Lutheran Church. (Accept by clicking below)

Accept Permissions

Parent Information

Please Fill out the Parent Form for Each Child you are enrolling for VBS this year. Thank you.

Parent First Name

Parent Last Name

Address

This address will receive a confirmation email

Main Phone

Other Phone

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone Number

VBS 2017 Child/Parent

Description

Please Fix the Following