6th Grade VBS 2026

Students Name

Date Of Birth

Entering 6th Grade

Yes

Allergies

Medical Concerns

Comments

Parents Names

This address will receive a confirmation email

Contact Phone 1

Contact Phone 2

Address

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone

Alternate Pickup Name

Alternate Pickup Name 2

Home Church Affiliation

In The Event Of A Medical Emergency, I Authorize Christ Lutheran Chuch To Seek Treatment By A Qualified Doctor For My Child While Attending Vacation Bible School, Including Calling 911.

Yes No

I Grant Permission For CLC To Photograph My Child And Use The Photos (Without Names) On CLC Bulletin Boards, CLC Facebook, And Other CLC Publications.

Yes No

You Are Registering For 6th Grade VBS, Do You Understand And Give Permission For Your Child To Participate In Daily Trips And Activities, Some of Which Will Be From 9am-4PM. Full Schedule Will Be Emailed To You.

Yes

Daily Arrival And Exiting Procedures: I Understand That I Must Sign My Child In AND Out Each Day Of VBS With Their Teacher(S). With Over 200 Children Attending VBS, We Take The Saety And Security Of All Our Children Very Seriously!

Yes

Payment (this covers the cost of trips and a shirt for each child. Please come at your earliest convenience as they are first come first serve for sizing). $45.00

Free Will Donation (Any extra donation will help us cover the costs for this great week for all kids).

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

July 13-17

Please fill out this form and click submit. You will then receive a confirmation email with more information.

6th Grade VBS 2026

Description

Please Fix the Following