Living Hope Vacation Bible School Registration

June 19-22, 2017                    8600 Horizon Drive South, Shakopee, MN 55379  

Items in Bold are required.
Parent/Guardian
Parent First Name
Parent Last Name
Address
City
State    
Zip
Email
Primary Phone () - Type
Alternate Phone () - Type
Alternate Phone () - Type
Member of Bloomington Living Hope Lutheran Church?
Transportation
We offer a free shuttle bus for those coming from our Bloomington location. Click to learn more.
Our family will ride the shuttle bus from Bloomington
Emergency Contact (different than the parent/guardian listed above)
Emergency Contact Name
Relationship
Emergency Contact Phone () - Type
Emergency Contact Alternate Phone () - Type
As parent/guardian of the children I register, I authorize the Bloomington Living Hope Lutheran VBS staff to administer first aid or emergency care to my child if needed. I will not hold Bloomington Living Hope Lutheran Church or its VBS staff liable for any care given in an emergency. Furthermore, I give permission to Bloomington Living Hope Lutheran to publish for its own use any pictures of my child taken during this program.