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Registracion del Participante

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Faith Lutheran Church

Location

602 S. 14th St.

Adel, IA 50003

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Contact DCE Madi Aeikens:

701-238-5222

dcemadi@faithadel.com

Primero, cuéntenos sobre usted:

Información de los Padres

Nombre

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Apellido

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Correo Electrónico

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Dirección 1

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Dirección 2

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Ciudad

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ZIP/Código Postal

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Teléfono de Contacto 1

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Teléfono de Contacto 2

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Nombre del Contacto de Emergencia

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Relación del Contacto de Emergencia

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Teléfono del Contacto de Emergencia

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Nombre de recogida alternativo

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Teléfono de recogida alternativa

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Afiliación de la iglesia local

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Comentarios

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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.

Cuéntanos sobre tu participante

(Must be 4 years of age by June 1 of 2026, completed one year of preschool, and potty trained up to 5th grade)

Nombre

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Apellido

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Grado Entrando

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Género

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Fecha de nacimiento

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Alergias

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Preocupaciones Médicas

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¿Tienes amigos con los que te gustaría estar juntos? Haremos todo lo posible para juntar a los amigos seleccionados en el mismo grupo, pero no podemos prometer que todas las solicitudes serán posibles.

Amigo 1 Nombre

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Amigo 1 Apellido

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Amigo 2 Nombre

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Amigo 2 Apellido

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Comentarios

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Family Physician

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Family Physicians Contact Number

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While Faith Lutheran welcomes all children, we are unable to provide 1:1 assistance. Has your child received 1:1 assistance at school during 2025-2026 school year?

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If yes, what is the contact name and number of the individual who will be attending VBS with your child?

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By checking here, you agree to the following:

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Do Not Send Your Child To VBS if They Have Been Sick In The Past 24 / 48 Hours

Code of Conduct: We reserve the right to contact the parent and, if necessary, send home any student who is disrespectful, uncooperative,
disruptive or in any way interferes with the learning experience of other students in his or her class.

Authorization of Participation: I have read and agree to abide by the above guidelines regarding attire
and conduct and hereby give permission for my child to participate in any activity or trips planned by the VBS staff and congregation.
I also authorize delivery of necessary emergency care by available medical personnel.

Appropriate attire No hats or caps. No flip-flops or similar footwear;
sneakers or similar sturdy shoes recommended. We are not responsible for injuries due to inappropriate footwear.

PHOTO NOTICE
Photos taken at this event may be publically displayed or used in promotional material by Faith Lutheran Church and Preschool. Please notify Faith Lutheran Church and Preschool or event organizers if you do not want a photo or video of you or your children to be displayed or used.

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