VBS 2024 Kids Reg Form

TEAM JESUS! - KIDS REGISTRATION
Ascension Lutheran Church
23401 23 Mile Rd., Macomb, Michigan 48042
(586) 569-9895

* Indicates required field

Child's Name *

First

Last

Birthdate *

Age/Grade *

Home Phone # *

Cell Phone # *

Parents' Names *

Address *

Apt. # *

City *

State *

Zip *

Email *

Emergency Contact *

First

Last

Relationship to Student *

Emergency Phone # *

Emergency Alt Phone # *

Food Allergies *

Yes No

Please List Allergies *

Medical Concerns *

Yes No

Please Explain *

Family Doctor's Name *

Doctor's Phone Number *

Siblings Attending TEAM JESUS! *

People who may pick up your child *

Church Affiliation *

Church Membership at *

Church Website Photos
On the Ascension web site strict rules are followed to help ensure the privacy and safety of pupils. The site contains comprehensive information about the church and its activities. Safety is paramount, and the staff checks all content before publishing it on the web. To this end, and after assessing the risk, children featured on the church’s website are only referred to by their first name.

Please Select *

Yes, you have permission to use my child’s photo on the Ascension Website. No, please do not use my child’s photo on the Ascension Website.

Public Relationship Photos
As we participate in our community, we have opportunities to provide photos of our activities in the newsworthy events. Photos may be used in the newspapers, internet, church promotions, and in church brochures and fliers. Children may be named in the publications as well.

Please Select *

Yes, you have permission to use my child’s photo in Ascension Public Relations material. No, do not use my child’s photo in Ascension Public Relations material.