Vacation Bible School 2026 – June 2-4

Esperanza’s Annual Vacation Bible School (VBS) Theme: Road Trip Tuesday, June 2, 2026 – Thursday June 4, 2026 from 9:00am to Noon Cost: Below registration form. 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 2, 2026 School Grade Entering Esperanza Member YesNo If Not an Esperanza Member, Other Church? 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].

Cost is $50 per child or $125 for a family registering 3 or more children Payment can be made by cash, check or Zelle Zelle QR code below:

Vacation Bible School 2026 – June 2-4

VBS Student Registration

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