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Participant Registration

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Registro en Español

Bethlehem Lutheran Church

Location

1423 8th Ave N

Jacksonville Beach, FL 32250

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Contact Darlene Maxwell:

904-249-5418

darbill1@bellsouth.net

First, tell us about yourself:

Parent Information

JESUS loves the Little Children and We do too !!!

Please complete this form to help us with Health & Safety at VBS !!

By completing this Registration form, I agree:

-that my child/children are:

*4 years old or older

*potty trained (no diapers)

*able to follow directions & stay with their tribe

-to leave kids cell phones at home

-to sign out my child at the pew at 12noon daily

-to go thru BLC Office for Early Pick Ups and Emergencies

Join us for our Annual VBS Closing & Cookout

Friday at 6:30pm

First Name

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Last Name

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Address 1

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City

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Contact Phone 1

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Emergency Contact Name

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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

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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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