Cartoon of children playing instruments with title VBS Registration

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Complete one form per child * Payment is due with registration * ($23/child before June 15; $28/child after June 15)

Policy on Photography and Photo Release

Registrants of the St. Paul Lutheran Church Vacation Bible School event agree to allow St. Paul Lutheran Church and its official photographer and/or videographer to photograph and videotape them in the context of the Vacation Bible School setting(s). Footage captured by the official St. Paul Lutheran Church photographer/videographer may be used without remuneration in future print and electronic promotional and archival materials. Participation in the event signifies assent and supersedes any prior photo permissions/agreements with St. Paul Lutheran Church or School.

Your relationship to Child ParentLegal Guardian
Note: You must be the child’s parent or legal guardian to complete their registration online. (If you are not parent/legal guardian you may register by submitting a paper form.)

Child’s Date of Birth (MM/DD/YYYY)*
(Must be age 3 by January 1 of the current year and potty trained)

Grade Level Completed Pre 3Pre 4KindergartenFirstSecondThirdFourthFifth

Attends St. Paul Lutheran Early Childhood Center or School? YesNo

Your Name

Address*

I am interested in information about:
St. Paul Lutheran ChurchSt. Paul School - Early Childhood Center 2-4 yearsSt. Paul School - Elementary - Kindergarten to Grade 5Having my child baptized at St. Paul Lutheran Church

Does the child have allergies?* YesNo

(If yes, please explain)*:

Emergency Contact Telephone Numbers
(If not applicable please type N/A)
Child's Mother

Emergency Contact Phone Number*

Child's Father

Emergency Contact Phone Number*

Other Contact Information
Please indicate adult responsible for child if parent(s) is/are not available during the day.

Would you like to donate snack/supplies? Yes

Would you like to help during VBS? Yes

Registration Fee

Payment is due with registration. Your child’s spot is saved upon receipt of payment.

Agreement to Conduct a Transaction by Electronic Means

By selecting the "I Accept" button, you are agreeing to sign and deliver this form electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this form. You further agree that your typing your name onto the signature line of this form constitutes your signature (hereinafter referred to as "E-Signature") as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and us. You also represent that you are authorized to sign this form for the purposes described in it.

Signature* (Type your name)