VBS 2019 Child/Student Registration
June 17-21 8:30-Noon | St. Paul Vacation Bible School - Miraculous Mission. 8:30-Noon. St. Paul Lutheran Church 602 Morgan Blvd. - Harlingen, TX 78550
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
*
Please select one option.
Male
Female
Select Option
Male
Female
Age of Child on June 17, 2019
*
Please select one option.
4
5
6
7
8
9
10
11
12
Select Option
4
5
6
7
8
9
10
11
12
Grade Entering Fall 2019
*
Please select one option.
PreK
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Select Option
PreK
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
T-Shirt Size
*
Please select one option.
Youth XSmall
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medum
Select Option
Youth XSmall
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medum
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)
*
Please select all that apply.
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)
*
Please select all that apply.
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
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Email
*
This address will receive a confirmation email
Main Phone
*
Other Phone
Emergency Contact First Name
*
Emergency Contact Last Name
*
Emergency Contact Phone Number
*
Submit
Description
June 17-21 8:30-Noon
St. Paul Vacation Bible School - Miraculous Mission. 8:30-Noon. St. Paul Lutheran Church 602 Morgan Blvd. - Harlingen, TX 78550
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