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Participant Registration

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Life Church

Location

1013 E. Bremer Ave.

Waverly, IA 50677

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Contact Waverly Community VBS:

708-526-3658

info@waverlyiowavbs.org

First, Tell Us About Yourself:

Parent Information

This page is for PARENT or GUARDIAN information.

First Name

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Last Name

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New text block

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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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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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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

This information is for kids who will be attending VBS. Please enter one child at a time.

First Name

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Last Name

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Gender

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Grade Entering

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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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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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School

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Home Church (if any)

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May we take pictures of your child for promotional purposes on the Waverly Community VBS Facebook page?

This field is required.

If you select "No" your child will have a sticker placed on their name tag. This sticker helps our media team make sure that we don't include you child in photos, and helps us catch any accidental photos of them during editing. It is your responsibility to ensure that this sticker remains on their name tag for the duration of VBS. If their name tag gets damaged, or the sticker wears off, please request a new one.

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