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Vacation Bible School Registration
Messiah Lutheran Church
VBS dates—(Five Days) Jully 8 through July 12. Registration is open to Ages 3 yrs
(potty trained) through 5th grade. VBS hours are 9:30 am – 12 pm – including a light
lunch to end each day’s session.
Child Information
Child's Name:
*
Age:
*
Child's Name:
Age:
Child's Name:
Age:
Child's Name:
Age:
Parent/Guardian Information
Parent/Guardian Name:
*
Emergency Contact
Phone Number:
Email Address:
🛈
Please select any medical diagnoses the child currently has
*
Asthma
Allergies
None
Please give details
Date Today:
*
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