VBS Registration

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Immanuel Lutheran Church
Vacation Bible School Registration
"High Seas Expedition"
Sunday, July 18 - Thursday, July 22, 2010
6:30 PM - 8:30 PM

Ages 3 years old through those going into 6th grade (last completed grade) are invited to attend.  


The cost for VBS is $15.00 per child (maximum of $40.00 per family).  Please make checks payable to Immanuel Lutheran Church.
Learn more about High Seas Expedition

You may download a printable registration form in .PDF format here that you can fill out and mail to the church office, or you may register online below and mail or deliver the registration fee to the main office.

* Indicates a required field

*Student's name:

*Street Address:

*City:   *State:   *Zip:

*Parents' Names:

*Home Telephone:   Cell:

Parent's work phone:   Email:

*Student's Age:   *Date of Birth:  

*Last School Grade Completed:
(Please note that students must be potty trained)

*Allergies or special needs:


*Emergency Contact (non guardian) Name:
*Relationship:

*Emergency Phone Numbers:

In case of emergency, if you can't contact me, contact *Dr. at (*phone)

*Hospital preference:

You have permission to treat my child.


We will be serving dinner every evening at 5:30 PM (menu can be viewed here).  Will your child be joining us for dinner? ($2.00 per day)
Yes     No   


** T-shirts will be provided to the children.  Please reserve it by selecting your shirt size below. 
Kids' sizes: Small (6-8) Med (10-12) Large (14-16)
Adult sizes: Medium Large   XL 2X
***Pictures will be taken of VBS events.  By registering for VBS at Immanuel, you are giving us permission to use photos of your child on our website and future promotional materials.