Faith Lutheran VBS Registration Form

Parent's Full Name *

Parent's Phone Number *

Parent's Email *

In case of emergency, please notify (provide name and phone number):

Health Information

Does your child(ren) have any allergies:

No

Yes

Please note: Faith Lutheran may not be able to accomodate all food allergies.

If "yes", please list them out:

Family Physician:

Physician Contact Number

Please list any restrictions to physical activity:

Other conditions/special concerns/medications to be aware of:

I hereby give permission for my child to participate in all activities as part of the Faith Lutheran VBS program, I authorize delivery of necessary emergency care by available staff. I also release the church from all liability, with the understanding that reasonable efforts will be made to insure my child(ren’s) safety and well-being during the VBS program. I give permission for Faith Lutheran to include VBS pictures with my child(ren) on social media. *

No

Yes

Parent/guardian signature: *

Clear

Please complete this form by June 29th, 2025.