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Mt. Olive Lutheran Church

Location

10408 W US 290

Austin, TX 78736

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Contact Mt. Olive Lutheran Church:

512-288-2370

finance@connectwithJesus.org

First, Tell Us About Yourself:

Parent Information

First Name

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Last Name

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Address 1

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Address 2

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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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Contact Phone 2

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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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Alternate Pickup Name

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Alternate Pickup Phone

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Home Church Affiliation

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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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Preferred Name/Nickname

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Gender

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Current Grade

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Date Of Birth

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Age As Of June 1, 2026

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Shirt Size

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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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Friend 2 First Name

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Friend 2 Last Name

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Friend 3 First Name

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Friend 3 Last Name

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Comments

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I hereby give my permission for Mt Olive Lutheran Church to use, publish, or disclose in newsletters, brochures, periodicals, posters, websites, or other media-related vehicles, any photographs, videos, audios or other promotional materials, in which, my child has appeared, spoken, written or otherwise been represented. My acknowledgement releases Mt Olive Lutheran Church to use any of the aforementioned materials. I understand that a copy of this release will be kept on file to indemnify Mt Olive Lutheran Church against any of their use of the materials indicated.

Media Release Agreement

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In participating with/at Mt Olive Lutheran Church, I understand I willfully and freely participate in this program under my own volition/personal responsibility and liability. As such, I fully understand that I participate solely under my own liability/family insurance plan germane to any risk factor that may arise during the trip/event, either foreseeable or unforeseeable, but not limited to: medical emergency, hospitalization, accident, dismemberment or death. I further understand and agree to hold harmless in law and in equity any of the Mt Olive Lutheran Church or Staff, or any individuals or congregations participating in these proceedings, for any negligence, or personal/group satisfaction/dissatisfaction pertaining to any aspect of the program or travel related to this event.

Liability Release Agreement

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I hereby certify that my son/daughter has my approval to attend VBS Rainforest Falls at Mt Olive Lutheran Church in 2026. I understand that all reasonable care will be taken to avoid accident or injury to my child while on all trips and events with Mt. Olive Lutheran Church and release the church staff and volunteers from liability. In the event of an emergency, I understand every effort will be made to contact me or the authorized person listed on this form. In the event that we cannot be reached, I grant permission to the staff of the trip/event to secure medical and/or surgical care for my child named above. I understand that Mt Olive Lutheran Church does not carry insurance for its youth members and agree to accept the expense of emergency care through my medical and/or personal resources.

Medical Release Agreement

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