Stellar VBS Registration • Good Shepherd Lutheran Church

Good Shepherd Vacation Bible School 2023

We invite all children ages 3 through 6th Grade (completed) as we launch into an out of this world event. Children will learn how to Shine Jesus' Light through Bible Stories, music, crafts, surprising discoveries, and more.

June 26 through 30, 2023

Monday through Friday 6:00pm to 8:30pm

Good Shepherd Lutheran Church
190 South Main St, Wilkes Barre PA 18702
goodshepherdwb.org

Click Here for Map and Directions

Child Information

First Name *

Last Name *

Date of Birth *

School Grade *

Tip: Last Grade Completed

Allergies/Medical Information/Special Needs

Photo/Video Authorization (Please select an option) *

Tip: We like to share images of all the fun children have at Good Shepherd. We also understand privacy and children at risk.

Parent/Guardian Information

Paren/Guardian Name *

Home Address *

Home Address Line 2

Home City *

Home State *

Home Zip Code *

Email Address *

Phone Number *

Allow text messages to this number? *

Yes

Tip: By checking yes you agree receive text updates and reminders.

Emergency Contact

Emergency Contact Name *

Emergency Contact Phone *

Liability Release and Photography/Video Authorization

By submitting this form you indicate your permission for this child to participate in Vacation Bible School at Good Shepherd Lutheran Church in Wilkes-Barre, Pennsylvania. In the event of an emergency, everything possible will be done to contact you or an other authorized person. If neither can be reached, you give full permission for a representative of Good Shepherd Lutheran Church to seek medical attention in your absence for the child. You FULLY RELEASE and discharge Good Shepherd Lutheran Church, its pastors, employees, directors, and volunteers from any and all liability in connection with any activities related to the Good Shepherd Lutheran Church Vacation Bible School program. If you selected to allow Good Shepherd to share photos and videos of this child, Good Shepherd may use photographs and videos for the purpose of sharing our ministries in print and online.