Vacation Bible School 2025 – June 3-5

Esperanza’s Annual Vacation Bible School (VBS)

Tuesday, June 3, 2025 – Thursday June 5, 2025 from 9:00am to Noon

Cost is $50 per child with a $125 family maximum fee

Ages: 3 (fully potty trained) thru 5^th grade

VBS Student Registration

Student Name Student's Address (Address, City, State, Zip Code) Student's E-mail Address (if exists or leave blank) Student's Phone Number (if exists or leave blank) Student's Birth Date Student's Age on June 3, 2025 School Grade Entering Esperanza Member YesNo If Not an Esperanza Member, Other Church? Student's T-Shirt Size Student's Emergency Contact Information Physician's Contact Information Student's Health Insurance Provider Student's Most Recent Tetanus Shot Date Student's Allergies Student's Medications / Restrictions / Chronic Health Considerations Full Name(s) of Parent(s) Address of Parent(s) Phone Number of Parent(s) Email Address of Parent(s) Alternate Emergency Contact / Has Permission to Pick-Up Child from VBS Additional Alternate Emergency Contact / Has Permission to Pick-Up Child from VBS Consent for Emergency Care
I/we as parent/guardian authorize representatives of Esperanza Lutheran Church to proceed in any and all medical procedures for this child/student. I/we acknowledge that my/our child will participate at their own risk and I/we will not hold Esperanza Lutheran Church or any representatives of Esperanza Lutheran Church liable for any injuries, including paralysis and death. Acceptance:

Any questions, please contact Deacon Connie at 480-759-1515 or email [email protected].

Vacation Bible School 2025 – June 3-5

VBS Student Registration

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