Vacation Bible School - St. John's Lombard 2025

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VACATION BIBLE SCHOOL
ST. JOHN'S LUTHERAN CHURCH AND SCHOOL
REGISTRATION FORM

July 14th-18th 9:30am-12:00pm
If your child is enrolled in summer camp at St. John's the week of VBS, they are automatically enrolled in VBS and do not need to register through Breeze.

SPACE IS LIMITED! Registration will close once we hit 150 participants.

Special Closing Service Saturday, July 19th AT 5:30PM
Cost: $25.50
Questions? Email: stjohnslombardvbs@gmail.com

REGISTRATION SECTION - Each participant must be registered seperately.

Participant Name (first and last)

Gender

Male Female

Date Of Birth

T-Shirt Size

Grade as of Fall 2025

CD or Digital Download - One Per Family

CD Digital Download

Member of St. John's Lutheran Church

Yes No

Home church if not a member of St. John's Lutheran Church

I hereby give permission for St. John's to use my child’s photograph in any media, including the Internet for promotional purposes. I also waive any rights, royalties, or claim to any sales or income from such photographs and give my permission to St. John's to use these pictures at their discretion.

Yes No

CUSTODIAL SECTION

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Phone Number

Parent/Guardian Home Address (if different)

EMERGENCY CONTACT SECTION

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Phone Number

Emergency Contact Relationship To Participant

If any of the conditions listed above are checked, please explain in detail...

List any allergies or adverse reactions...

PAYMENT SECTION

Each participant will be charged $25.50 (this includes a .50 service charge) for the St. John's VBS in 2025. This cost will pay for t-shirt, supplies, family cd, and treats. St. John's uses the company "Breeze" to collect the deposits. Breeze will be shown on your credit card statement, not St. John's Lutheran Church and School.

Deposit $25.50

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Vacation Bible School - St. John's Lombard 2025

Description

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