Salem 2018 VBS Registration Please complete this registration form for your child(ren). VBS is open to children age 3 through 6th grade.Three-year-olds should be 3 by August 1, 2018. VBS cost is $15 per child with a $45 maximum per family.Scholarships are available; please contact Pastor Dave for scholarship details. Question Title * 1. Name of Child(ren) Child 1 Child 2 Child 3 Child 4 Child 5 Question Title * 2. Name(s) of Parent(S)/Guardian(S) Question Title * 3. School Grade in Fall of 2018 Child 1 Child 2 Child 3 Child 4 Child 5 Question Title * 4. Birthday(s) and Age(s) Child 1 Child 2 Child 3 Child 4 Child 5 Question Title * 5. Street Address, City, State, Zip Question Title * 6. Home Phone and Cell Phone Question Title * 7. Email Address Question Title * 8. Emergency Contact Name and Contact Number Question Title * 9. Name and Relationship of Adults Approved to Pick-Up your Child(ren) from VBS Question Title * 10. Medical Concerns (including allergies) Child 1 Child 2 Child 3 Child 4 Child 5 Question Title * 11. Behavioral Concerns Child 1 Child 2 Child 3 Child 4 Child 5 Question Title * 12. Do you authorize Salem Lutheran Church to publish photos of your child(ren) in congregational publications? Yes No Question Title * 13. T-SHIRT SIZE (YOUTH S M L XL) Child 1 Child 2 Child 3 Child 4 Child 5 Question Title * 14. Parent/Guardian Electronic Signature Done