2026 VBS Participant

July 13-17 9am-Noon | Please fill out this form and click submit. You will then receive an email from us with instructions on picking up your shirt/music, etc. We are so excited to have you join us for VBS!

Childs Name

Grade Entering this fall or age if preschool

Please select one option.

3 Years Old 4 Years Old Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade

Gender

Date Of Birth

Allergies

Medical Concerns

Comments

I Understand That All Pre-School Aged Children Must Be Potty Trained In Order To Attend VBS. No Pullups.

Please select all that apply.

Yes

Parents Name

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.

Please select all that apply.

Yes No

I Grant Permission For Christ Lutheran To Photograph My Child And Use The Photos For The Daily Slide Show Shown Each Day At The End Of VBS And During The Closing Program.

Please select all that apply.

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.

Please select all that apply.

Yes No

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

Please select all that apply.

Yes

Payment (this covers the cost of a shirt for each child. Please come at your earliest convenience as they are first come first serve for sizing). 25.00

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 9am-Noon

Please fill out this form and click submit. You will then receive an email from us with instructions on picking up your shirt/music, etc. We are so excited to have you join us for VBS!

2026 VBS Participant

Description

Please Fix the Following