VBS 2018 Registration VBS Online RegistrationMain Contact Name * Main Contact Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepaNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabweCountry Main Contact Phone * Main Contact Email * Emergency Contact Name * Emergency Contact Phone Number * Parent Volunteer Yes, I can help the week of VBSI can help in prep work before VBS I consent to the use of my child/children's photo, video image or audio recording taken during this event to be used by Bethlehem Lutheran Church as they see fit. *YesNo PARENTS OF 4TH AND 5TH GRADERS ONLY!! By typing my name below, I am aware and give permission for him/her to travel off-site for mission activities. Number of Children Attending *Registration Cost is $30 per child. If you are registering more than 5 children, please fill out multiple Registration Forms.1 Child - $302 Children - $603 Children - $904 Children - $1205 Children - $150 Child 1 Name * Gender *BoyGirl Birthdate * Grade Entering in Fall 2018 *3 year old preschool4 year old preschool5 year old preschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade T-Shirt Size *Youth X-SmallYouth SmallYouth MediumYouth LargeYouth X- LargeAdult SmallAdult MediumAdult LargeAdult X-Large Please list any special needs, dietary restrictions and allergies. Child 2 Name Gender BoyGirl Birthdate Grade Entering in Fall 2018 3 year old preschool4 year old preschool5 year old preschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade T-Shirt Size Youth X-SmallYouth SmallYouth MediumYouth LargeYouth X- LargeAdult SmallAdult MediumAdult LargeAdult X-Large Please list any special needs, dietary restrictions and allergies. Child 3 Name Gender BoyGirl Birthdate Grade Entering in Fall 2018 3 year old preschool4 year old preschool5 year old preschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade T-Shirt Size Youth X-SmallYouth SmallYouth MediumYouth LargeYouth X- LargeAdult SmallAdult MediumAdult LargeAdult X-Large Please list any special needs, dietary restrictions and allergies. Child 4 Name Sex BoyGirl Birthdate Grade Entering in Fall 2018 3 year old preschool4 year old preschool5 year old preschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade T-Shirt Size Youth X-SmallYouth SmallYouth MediumYouth LargeYouth X- LargeAdult SmallAdult MediumAdult LargeAdult X-Large Please list any special needs, dietary restrictions and allergies. Child 5 Name Sex BoyGirl Birthdate Grade Entering in Fall 2018 3 year old preschool4 year old preschool5 year old preschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade T-Shirt Size Youth X-SmallYouth SmallYouth MediumYouth LargeYouth X- LargeAdult SmallAdult MediumAdult LargeAdult X-Large Please list any special needs, dietary restrictions and allergies. Please review your registration form and make sure all your information is correct. You will receive a confirmation of your registration at the email you supplied above. Once you submit your registration, you will be redirected to the VBS Pay Online page.
