VBS 2024 The Great Jungle Journey Registration Form Please complete the form below to register for 2024 VBS at Our Savior Lutheran. VBS Registration Form Name(Required) First Middle Last NicknameFor the name tag (optional)Birth Date(Required) MM slash DD slash YYYY Grade in Fall 2024(Required) Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade 6th Grade Gender(Required) Male Female T-Shirt Size(Required) Youth XS Youth S Youth M Youth L Youth XL Adult S Adult M Adult L Address(Required) Street Address Address Line 2 City ZIP Code Parent InformationMother's Name(Required) First Last Mother's Email(Required) Mother's Phone(Required)Mother Text Messages(Required) Yes No Father's Name(Required) First Last Father's Email(Required) Father's Phone(Required)Father Text Messages(Required) Yes No Emergency Medical InformationAny medical conditions?(Required) Yes No List all medical conditionsAny Special Needs?(Required) Yes No List all special needsEmergency Contact & PickupEmergency Contact Name(Required)(other than mom or dad)Emergency Contact Phone(Required)Relationship to Student(Required)List all adults including parents authorized to pick up your childFirst and Last Name - Photo ID required - One name per lineOtherHow did you hear about Our Savior Lutheran's VBS?(Required) I am a member of OSL Family / Friend Facebook Instagram Street Banner OSL Website Other OtherAdditional CommentsPermissionsMedia Consent(Required)I give my consent to OSL to take pictures or video of my child(ren) for publicity use on the youth bulletin board, on the youth room wall, in newspaper articles, brochures, Facebook/Social Media, or on the OSL website. I agree(Required)Bulletin Name Consent(Required)I give my consent to OSL to use only first name on the youth bulletin board, on the youth room wall, in the newspaper articles, brochures, on Facebook/Social Media or on the website. I agree(Required)Emergency Consent(Required)In case of emergency, I authorize Our Savior Lutheran Church to seek medical attention for my child. Our Savior Lutheran Church does not assume any financial responsibility, but will provide or arrange for emergency care. By submitting this form, you are giving the appropriate VBS personnel authority to call EMS, to transport, or to obtain medical care if you or the alternate adults cannot be reached. I agree(Required)Authorized Signature(Required)