Family of God Lutheran Church
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VBS Registration form 2017
Family of God Vacation Bible School Registration
June 12 - 15, 2017
• VBS will run Monday –Thursday June 12-15, 9 am to noon
• Cost $25.00 ($50 max per family)
• Potluck and Performance Thursday evening at 5:30 pm
What to expect:
* VBS will focus on Martin Luther, our hero of faith for 500
* snack will be provided (please note any food allergies)
What to bring:
*Shoes you can run in
*towel and clothing you can get wet in (on water day)
• Pick up daily at noon
• In case of family emergency contact Family of God at: 763-424-8625
2017 VBS Registration Form
Grade completed as of June 10:
Parent/Guardian Name (s)
Parents Contact Number (s)
Emergency Contact Name
Relationship to Child:
Any allergies, health concerns, medication, or beneficial information for our staff to know?
Release from Liability:
Release from liability: Guardians hereby authorize my son/daughter to participate in said activity. Guardians hereby release, forever discharge and agree to hold harmless, Family of God Lutheran Church, from the described e vent, and the directors thereof from any and all liability, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the participant that occur while said person is participating in the described event. The undersigned further hereby agrees to hold harmless and indemnify Family of God Lutheran Church, its directors, employees and agents for liability sustained by said acts of said participant, including any expenses incurred. The undersigned also gives permission for photos to be used online and in print.
Medical release: The undersigned further consents to the administration of first-aid and/or doctor’s care, or any other form of medical treatment necessitated by illness or injury that may require the same. In the event of the necessity of such care or treatment as heretofore described, the undersigned agrees to hold harmless and indemnify Family of God Lutheran Church, its directors, employees and agents from any acts of misconduct, and/or failure to act on the part of those chosen to administer medical aid on behalf of the participant.
For Parent/Guardian Signature:
For parent/guardian signature: I also understand that if my child is intentionally creating problems or is found in possession of controlled substances, I may be contacted to provide immediate transportation home at our family’s expense.
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Family of God Lutheran Church:
8625 Zane Ave N,
Brooklyn Park, MN
Summer Worship Service:
Sundays 9:30 am