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2021 Vacation Bible School Registration

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2021 VBS dates are not yet set.

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Please Complete All Boxes

Child's Name: First and Last

Street Address:

City:

State:

Zip:

Date of Birth:

Last Grade Completed (K-6):

Tee Shirt Size:

Parent or Guardian's Name:

Street Address:

City:

State:

Zip:

Phone:

Email:

Emergency Contact's Name

Emergency Contact's Phone #

Please list special needs or allergies:

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For safety reasons, no flip-flops or other slip-on sandals, please.

Thank you for registering for VBS.

Disclaimer:

By entering these premises, you understand that you may be photographed, filmed, or videotaped and you hereby give St. Luke's United Methodist Church the unqualified right to take pictures and/or recordings of you and your child and grant the perpetual right to use your likeness, image,

photo (collectively, “image”), without compensation, for broadcast or exhibition in any medium and to put the finished pictures / recordings to any legitimate use without limitation or reservation. You hereby waive, release and forever discharge St. Luke's United Methodist Church from and against any and all claims or actions arising out of or resulting from any use of your image.

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