2021 VBS Registration Form – Trinity Lutheran Church

Complete all the information on the form and click the SUBMIT button. You will receive an email acknowledgment once you submit the form.

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Child's Name*

Child's Gender (Choose One)

Child's Age*

Date of Birth*

Last School Grade Completed*

Name of Parent(s)*

Street Address*

City*

State*

Zip*

Parent Caregiver's Cell # (including area code)*

Home Telephone (including area code)*

Home E-mail Address*

Home Church

Allergies, medical conditions, or special needs*

In case of emergency contact*

Emergency Contact Phone number*

Emergency contact relationship to child*

Crew number or name (for church use only):

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