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Allergies
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Special Needs or Accomodations Needed
Child Pick-Up Information
Name of Adult Picking Up Child Each Day
Name of Secondary Adult Who May Pick Up Child
Children may only be picked up by one of the adults named above. Adults are required to show a photo ID during pick-up. Children will not be sent home with any unverified adults.
You can also name a person who is especially prohibited from picking up your child (due to custody, etc). Our volunteers will make special note of these individuals and will inform you if these individuals attempt to contact your child.
This person or persons MAY NOT pick up my child
Primary Emergency Contact
Emergency Contact First Name
Emergency Contact Last Name
Phone Number
Secondary Emergency Contact
Emergency Contact First Name
Emergency Contact Last Name
Phone Number
Photography Waiver
During VBS, photos and video may be taken of the group and/or individual children. These photos may be shared on social media and/or the church website. By checking the box below, you consent to these photos and/or videos being taken of your child.
I give Hope Lutheran Church permission to take photos and/or video of my child and share them on social media, the church website, or other Hope Lutheran Church publicity platforms.
Yes
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