ADULT PARTICIPANT REGISTRATION FORM

Thank you for joining us at Ascension Lutheran Church for Operation Restoration VBS! Use this form to register.

Name

First Name

Last Name

Home Phone

(###)

###

####

Cell Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Congregation (If any)

Please list any allergies (including food allergies) the VBS staff should be aware of

T-shirt Size

Small

Medium

Large

X-Large

Emergency Contact Information

In case of emergency, contact person if parent/guardian cannot be reached:

Name

First Name

Last Name

Phone

(###)

###

####

Relationship to participant

Throughout VBS, we may take videos or photos of the participants in action. We only share photos and videos of people who have signed a Media Release Form. Check here if you have signed the media release form.

I have signed the Media Release Form

E-signature

Provide your E-signature by typing your full name in the box below.