2025 VBS registration

2025 Vacation Bible School Registration

Please complete the registration form below and return it to the church. We only need one form per family.

* Indicates required field

Parent's Name *

First

Last

Phone Number *

Parent's Name *

First

Last

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Emergency Contact & Phone # *

People who may pick up the child(ren) *

Physician's name & clinic *

Child's Name *

Age *

Birthday *

Grade completed *

Allergy/Medical Conditions *

Child's name *

Age *

Birthday *

Grade completed *

Allergy/Medical Conditions *

Child's Name *

Age *

Birthday *

Grade completed *

Allergy/Medical Conditions *

Child's Name *

Age *

Birthday *

Grade completed *

Allergy/Medical Conditions *

Child's Name *

Age *

Birthday *

Grade completed *

Allergy/Medical Conditions *

I give permission for my child(ren) to participate fully in the VBS program.

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 during VBS pictures/films may be taken to help us remember the event. I give permission for my child’s picture/film to be used in church publications such as but not limited to: newsletter, web-site, facebook, and newspaper.

I have read and agree to the above statements *

Yes

Signature *

Date *

Submit

2025 Vacation Bible School Registration

Please complete the registration form below and return it to the church. We only need one form per family.

St. Paul's Lutheran Church303 E. 4th StreetUte, IA 51060

St. Paul's Lutheran Church
303 E. 4th Street
Ute, IA 51060