VBS 2025 Sign-Up

Cost: $10 per child, option to pay online available after you submit your form, or you may pay with cash or check in the church office.

Dates: June 16th-19th
Pre K-5th: Monday-Thursday 8:30-11:30

*CHILDREN'S PERFORMANCE AND BBQ LUNCH WILL BE THURSDAY JUNE 19TH 11:30-1:00 P.M.

*Early care & breakfast is an option for those who need.
Please check that option on this form if needed.

*Transportation will be provided AFTER VBS ONLY for Okoboji and Spirit Lake Y kids and Little Sprouts in Milford. Please contact Tammy Carr children@3cross.org if your child will need transportation.

Camper Information

Name

This address will receive a confirmation email

Mailing address

Fall 2025 Grade

Age (at time of VBS)

First time attending our VBS?

Yes No

Is your child a fairly regular participant at First Lutheran?

Yes No, we attend a different church No, we are not from the area No, we don't regularly attend a church No, other

Siblings or Friends also attending:

Please select box if you need early care and/or transportation

Early care Transportation Breakfast

*Pre-K-5th grade will be provided a snack.

6th graders & Up are Welcome to sign up to Volunteer

Parent/Guardian & Emergency Contact Information

Parent/Guardian Name(s)

Best phone number to reach parent/guardian(s) during week of VBS:

Emergency Contact (should be someone other than parent/guardian)

Emergency Contact Phone:

General Health Information

Chronic or recurring illness or medical condition that may affect your child's time at VBS:

Allergies (food, bees, etc.) and severity:

Dietary Restrictions:

Any medications (including epi pens) that will need to be available for your child during VBS:

Other suggestions that may help make your child's VBS week better:

Please check if immunizations are up to date:

DPT Pollo Immunization MMR (Measles/Mumps/Rubela) Tetanus

Date of last tetanus (MM/YY)

Insurance Information

Insurance Company

Policy #

Holder's Name

Permissions

I give my permission for my child to participate in all aspects of the VBS program. I understand that every effort will be made to contact me if my child needs emergency medical treatment. I authorize medical personnel, the local VBS coordinator or Day Camp staff to secure any medical or emergency treatment as deemed necessary for my child. That I or my insurance company will pay for any medical treatment if costs are incurred. I understand choosing to send this child to VBS may increase their risk of being exposed to COVID-19 and other illnesses, agree to pre-screen this child for symptoms prior to arrival at VBS, not send this child if I suspect they are ill, and understand there may be safety requirements expected of this child.

Yes

I give my permission to First Lutheran Church to make or use pictures, digital images, video or other reproductions of my child and to put the finished pictures, images, or videos in publications, social media, or other printed or electronic materials related to the role and function of First Lutheran Church.

Yes No

Any additional comments, questions, or concerns for Tammy Carr/First Lutheran Church before VBS:

VBS 2025 Sign-Up

Description

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