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Participant Registration

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Registro en Español

The Life Lutheran Church

Location

1 Old Westbury Rd.

Old Westbury, NY 11568

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Contact Nancy Rickman:

516-333-3355

vbs@thelifeny.org

First, Tell Us About Yourself:

Parent Information

Attention Families: All participants must be entering the Kindergarten grade level or higher in September 2024 to register for VBS.

To complete your child's registration, please be sure to email a copy of your child's birth certificate to VBS@thelifeny.org

IMPORTANT: Registration is not complete until the church office receives the birth certificate. Thank you!

First Name

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Last Name

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Address 1

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City

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State/Province

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ZIP/Postal Code

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Contact Phone 1

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Text Message Phone

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Emergency Contact Name

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Emergency Contact Relationship

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Emergency Contact Phone

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Click here for your FREE Friends With God Kids Activity Pack

By checking the box you will be emailed your Free Friends With God Kids Activity Pack.

You are also agreeing to receive emails about family resources from Lifetree. You can unsubscribe at any time. We value your privacy. Your information will not be shared with a third party. Lifetree is a division of Group Publishing, the creators of Group VBS and other faith-building resources. Click to learn more about Lifetree.

Tell Us About Your Participant

First Name

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Last Name

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Grade Entering

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Gender

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Date Of Birth

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Allergies

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Medical Concerns

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Do you have friends you would like to be placed with? We will do our best to group selected friends together in the same crew, but we cannot promise all requests will be possible.

Friend 1 First Name

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Friend 1 Last Name

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