Please fill out this form as completely as possible to register your student for Vacation Bible School at Lord of Life Lutheran Church.
Required fields are marked with a red asterisk (*).
Children must be 3 years old by September 30, 2017.
Please indicate whether your child has any of the following medical or educational plans, either at school or home:
The following list of over-the-counter medication is available in the Lord of Life Lutheran Church first aid kits. These are available to treat minor afflictions. The dosage is determined according to the size/age of child, and the specific direction listed on the medication. Please indicate whether or not these medications may be given to your child as needed.
You will be contacted immediately if illness develops or emergency treatment is required.
By filling out this form, you acknowledge that the student listed above is under your custodial care and should receive the medication, vitamin, or modified diet as indicated below.
Please keep medication in its original container and in a zip lock bag labeled with the student's name and hand it to the small group leader.
By registering your student, you acknowledge that your son or daughter may receive medical treatment with aid from designated Lord of Life Lutheran Church staff or volunteer. If you DO NOT wish for your child to receive treatment in case of an emergency, please check the box below.
By registering your student, you acknowledge that Lord of Life Lutheran Church may take pictures and/or video of your child which may be used within the building or in publicity materials - including but not limited to the website and Facebook page. Your child will not be identified by name.
By typing in the Signature field below and submitting this form, you are indicating that the above information is accurate and you are registering your student to participate in Vacation Bible School at Lord of Life Lutheran Church.
Your student has been registered for VBS at Lord of Life!