Trinity Lutheran Church

Register for Sunday School VBS

Questions

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Student Name *


First Name	Last Name

Age *

Gender

Select from list

Medical Issues or Special Needs

Parent Name *


First Name	Last Name

Address


Address

Address Line 2

City	State	Zip Code

Home or Cell Phone *

Phone Number

Email Address

Emergency Contact *

Emergency Phone Number *

MEDICAL RELEASE: I give my permission to the Sunday School VBS Staff to administer basic first aid to my child (name above) in the event of an injury. I understand that the Sunday School VBS Staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me.

I have read the medical release. *

Select one

Yes

* required