Mission Lutheran Church of Laguna Niguel - VBS - Week Long Leaders Only Registration

VBS - Week Long Leaders Only Registration - 2017

Vacation Bible School is June 19th through June 23, 2017 from 1:00 pm to 4:00 pm.
Please complete a separate form for each child attending.
Child’s Name	*
Age child will be on July 1, 2017	*
Child’s Gender	*
Address (Street, City, Zip) *
Home Phone
Cell Phone	*
Your Email Address	*
Parent/Guardian Name	*
Emergency Contact (Name, Relationship, and Phone Number) *
Allergies or Other Important Information *
Birthdate	*
Grade completed this school year	*
Name of special friend your child might like to be with? (We are not guaranteeing placement with this friend, but we will make every effort to accommodate the request.)
Child’s T-Shirt Size	*
PERMISSION SLIP, MEDICAL CONSENT AND GENERAL RELEASE
I hereby give permission for my child, a minor, to participate in the activities/outings of Mission Lutheran Church (MLC) and I have listed any physical impairments that would affect my child’s participation. I authorize MLC, its staff members or counselors to act for me according to their best judgment in any emergency requiring medical attention and give consent for any and all medical treatment deemed appropriate and necessary by the attending medical professional. I hereby waive and release MLC, the staff and counselors from all liabilities for injuries or illnesses incurred during activities/outings.
I hereby acknowledge and consent to the aforementioned Permission Slip, Medical Consent and General Release.
PHOTO RELEASE AUTHORIZATION
I hereby acknowledge and consent to my child being photographed as part of the event and consent to my child’s photo used in any church publications, website, social media, etc.
EXPECTATIONS AND GUIDELINES
The goal of Vacation Bible School is to provide a fun and positive learning environment for all participants. Should your child choose to not follow the expectations and guidelines of the program, you will be contacted and appropriate action will be taken.
Follow directions of leadership
Demonstrate proper behavior
Be respectful of church property and the property of others
I have read and understand the Expectations and Guidelines of participation.	*
In what way would you like to be part of this special week in your child’s life?	*
Other way you would like to be part of this special week?
For more information or questions, please contact Jamie Beaudry, Director of Children and Family, at jamiebeaudry@missionlutheran.org.
Please type in the box to the right »	*