Participant Registration

Go Back

Registro en Español

Bethlehem Lutheran Church

Location

1423 8th Ave N

Jacksonville Beach, FL 32250

Map It

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 !!!

Must Register by May 19th for Free VBS shirt for kids ❤️ Wear the shirts all year and share your faith !!

Please complete this form to help us ensure the Health & Safety of all the children here at VBS !!

By completing this Registration form, I consent that my child/children:

-are entering VPK4 thru rising 5th Graders

-potty trained (no diapers)

-respectable, able to follow direction & stay with their tribe

-I will be available by phone # provided for illness, injury, or behavior

-will leave toys, snacks & cell phones at home

-may be photographed and/or video recorded on our slideshow

-will be picked up at tribe pew at 12noon with VBS Pick Up ID (provided)

-early Pick Up must go to BLC Office with VBS Pick Up ID (provided)

Don’t miss out:

VBS Closing/Cookout

Friday June 14th

6:30pm

First Name

This field is required.

Last Name

This field is required.

Address 1

This field is required.

City

This field is required.

Emergency Contact Phone

This field is required.

Alternate Pickup Phone

This field is required.

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

This field is required.

Last Name

This field is required.

Grade Entering

This field is required.

Gender

This field is required.

Date Of Birth

This field is required.

Shirt Size

This field is required.

Allergies

This field is required.

Medical Concerns

This field is required.

You can list a friend or sibling you would like your child to be with in a tribe . We will do our best to assign them together, but we cannot promise all requests will be possible. Full Name

This field is required.

— or —