Peace Lutheran Church

Evangelical Lutheran Church in America
(320) 685-7656

Vacation Bible School Registration

Instructions:

Complete the form below for one child, then click Submit.  Complete the form again for each additional child, clicking Submit each time.  When finished registering all campers, click the “Pay Now” button at the bottom of the page.


STUDENT FULL NAME
Gender
Age
Grade Completed
PARENT 1 FULL NAME
Phone
Address, City, State, Zip
Email
PARENT 2 FULL NAME
Phone
Address, City, State, Zip (if different from above)
Email
TransportationNo thanks-we have transportation covered
Yes-I need transportation for my child(ren). Please call Amy Leither at 320.309.8107 to make arrangements.
I give permission for my child to participate in Luther Crest’s Day Camp, to take part in the normal activities, and I authorize the camp doctor to provide any necessary emergency medical care. I understand Luther Crest assumes secondary insurance coverage; the camper’s family assumes primary coverage. I also give Luther Crest permission to use any photograph of my child taken at camp in future promotion of Luther Crest.
Parent's Signature
Type the letters/words as you see them on your screen.