Form – 2026 VBS Registration | Immanuel Lutheran Church and School

VBS Registration 2026

You may use this form to register your children in Vacation Bible School. Upon submission of this form, you will receive a message that confirms successful enrollment. If you have questions or need assistance, please contact the church office at (847) 359-1549. Registration closes at 11:59pm on Sunday, June 14, except for those with special permission.

Registration Fees

The cost of Vacation Bible School Camp program is $50 per registered child. As a courtesy to our volunteer camp “Leaders” and “Assistants,” A $10 discount per child is offered for EACH day volunteered! Therefore, if you volunteer for all 5 days of VBS, your registration is FREE! This discount opportunity will be automatically applied upon completion of the form. All payments are non-refundable.

Enrollment Instructions

All fields marked with an asterisk are required. If you have more than one child to register, be sure to answer “Yes” to the “Do you have another child to register?” question at the end of the form. Doing this will allow you to enroll another child. Once all of your children have been entered, and the answer to the above question becomes “No,” then you will be presented with the final questions, volunteer discount opportunities and payment options. Safe and secure payment can be made with Paypal or any major credit card.

VBS Camp 2026 Registration Form

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

I understand that this registration form is for Vacation Bible School at Immanuel Lutheran Church in Palatine, Illinois (200 North Plum Grove Road).*

Yes, I understand!

There are many churches with the name "Immanuel Lutheran," so this is to ensure that you’ve come to the right place!

Is this Child Already Enrolled in our Discovery Camp Program?*

Yes

STOP! - No Further Action Is Required!

Enrollment in our Discovery Camp Program automatically includes enrollment in our VBS Camp. No further action is required. There is no need to complete and submit this form. Thank you for your support of Immanuel's Youth Programs!

Parent/Guardian Information

Name*

First Last

Email*

We will respect your email's privacy

Secondary Email (optional)

Home Phone

Cell Phone*

Work Phone

Address*

Street Address Address Line 2 City State ZIP / Postal Code

Your Family's Church Affiliation*

Immanuel Lutheran

Prince of Peace

Willow Creek

First Methodist

None

Other

Student Information

Please enter the following information for EACH child that is being registered. If registering more than one child, please state that this is the case by answering "Yes" to the "Do you have another child to register" question, at the end of this form.

Are You A Member or Guest/Non-Member of Immanuel?*

Member

Non-Member / Guest

Child's Name*

First Last

My Relationship to this Minor Is*

Mother, Father, Legal Guardian, Aunt, Uncle, Grandparent, Etc.

Gender*

Male

Female

Current Age*

Please enter a number from 4 to 11.

Birthday*

MM slash DD slash YYYY

To be eligible for Vacation Bible School, a child must turn 4-years-old by September 1, 2026.

Grade in Fall 2026*

Note: First-year preschoolers are not eligible for enrollment. If a grade is not listed, then the class is full.

T-Shirt Size*

Youth - Small

Youth - Medium

Youth - Large

Adult - Small

Adult - Medium

Adult - Large

Adult - Extra Large

Note: Students should wear their VBS T-shirts each day to be easily identifiable as a VBS participant.

Any Known Allergies?*

Yes

Allergy Information

List the Known Allergies*

Enter the known allergies, separated by commas

Symptoms following exposure to a particular material can include: (please check all that apply)*

Hives and itchiness on any part of the body

Nausea, vomiting, diarrhea

Difficulty breathing or swallowing

Panic or sense of doom

Throat tightness or closing

Swelling of any body parts, especially eyelids, lips, face or tongue

Fainting or loss of consciousness

Coughing, wheezing or change of voice

None of the above listed symptoms (please specify below)

Please list any additional symptoms here:

Please list any general precautions taken at school, at home, etc.:*

Please list emergency measures in response to a reaction (i.e. use of Epi-Pen, etc.)*

Is this a severe allergy that requires an Epi-Pen?*

Yes

Is your child accustomed to carrying his/her own Epi Pen, or would you like your child’s group leader to carry it in his/her bag? (The bag will stay with the leader at all times)*

My child will carry his/her own Epi-Pen

I give permission for the group leader to carry my child’s Epi-Pen

Is there anything else we need to know that will assist us regarding health and safety matters during VBS week?*

Permission to Treat*

I agree that the church, including its staff and VBS volunteers, may carry out the emergency measures listed above and that this information will be shared, as necessary, with the VBS leaders and health care providers.

Liability and Publicity Release

Liability and Publicity Release For This Child*

By checking this checkbox, I am acknowledging that I am signing this form electronically and accept the terms outlined in the Liability and Publicity Release below.

LIABILITY RELEASE: In consideration of being allowed to participate in the Events sponsored by Immanuel Lutheran Church & School, Palatine, IL; and in consideration of the benefits derived therefrom, I on my behalf and, if applicable, on behalf of the Minor named hereby release the Northern Illinois District of the Lutheran Church-Missouri Synod, Immanuel Lutheran Church and School and their present and former trustees, officers, directors, boards, shareholders, employees, agents and their heirs, administrators, executors, successors, and assigns release from any and all claims, demands, actions, suits, proceedings, damages, claims and liabilities of any kind, whether known or unknown, which arise from or are connected with my or the Minor’s participation in the event. I am aware that in addition to typical activities such as Bible study, worship, sight-seeing, using public transportation, and meal functions; that I or the Minor may participate in various other activities that may involve some risks, such as service projects and recreational activities. I have read the informational materials about this Event and the site and understand the risks involved in the planned activities. I recognize that the conditions, equipment or standards in some of the places which I or the Minor will travel may not be of the same quality level or standards as the conditions, equipment or standards to which I am accustomed. I realize further that there are certain health risks as well as other risks to me or the Minor and our property. I enter into participation in this Event with knowledge of those risks and acceptance of responsibility for any harm, injury or damage resulting therefrom. If for any reason I am unable to complete my stay at the Event, I assume full responsibility for expenses incurred for my return home. In the event of an emergency, I hereby authorize a leader of this activity, as an agent for me or the Minor, to consent to: any x-ray, examination; medical dental or surgical diagnosis; treatments; hospital care advised and supervised by a physician, surgeon or dentist (as appropriate) licensed to practice under the laws of the state or country where services are rendered, either at a doctor’s office or in a hospital. I expect to be contacted or my family contacted as soon as possible. I understand that this document constitutes a full and complete waiver and release of any and all possible claims for any act or omission, including claims for negligence regarding injury or property damages, arising out of my or the Minor’s participation in the Event. I understand that this release applies to, covers, and includes unknown, unforeseen, unanticipated, and unsuspected risks, damages, losses, or liabilities and the consequences thereof, which result from the matters herein before inferred to as well as those not disclosed and known to exist. The provisions of any state, federal, local or territorial law or statue providing in substance that releases shall not extend to claims or damages which are unknown or unsuspected to exist at the time are hereby expressly waived by me. Furthermore, I do hereby expressly stipulate, and agree to indemnify and hold forever harmless the Northern Illinois District of the Lutheran Church-Missouri Synod, Immanuel Lutheran Church and School, and their agents, servants, successors, assigns, boards, directors, trustees, officers, employees, and other representatives against loss from any and all present or future claims, demands or actions in law or in equity that may hereafter be made or brought by me or the Minor or on our behalf, related to or resulting from any occurrence, act or omission during the Event, or travel to and from the Event. I also hereby release and waive any and all claims for liability against any of the host churches, host institutions and the employees, agents, officers, directors, shareholders, contractors and assigns of such host church or host institution or the owner of any sites that I or the Minor may be at during the Event. By acceptance of participation in the Event, the undersigned agrees to the foregoing and also agrees that the Northern Illinois District of the Lutheran Church-Missouri Synod, Immanuel Evangelical Lutheran Church Palatine, Immanuel Lutheran Church and School, and their employees and other representatives, shall not be liable for loss, damage, injury or inconvenience caused by or resulting from the malfunction of transportation, equipment, strikes, acts of war or insurrection, fire, delays, theft or itinerary or schedule changes or cancellations. PUBLICITY RELEASE: I understand photos, videos and sound recordings of students and children may be used on the Immanuel website, yearbook, brochures or other such media for the purpose of public relations, promotion of Immanuel events, recruitment, student records, historical records or other activities that serve to publicize Immanuel Lutheran Church & School. I further understand that all photos, videos and sound recordings will be taken in a public venue and will not offend Christian or civil standards, and that no written identification of any individual student/child will accompany photos, videos, or sound recordings other than those used for student and historical records. I authorize Immanuel Lutheran Church & School to take photos, videos, and produce sound recordings of the above named student or child and to use such photos, videos and sound records.

Release Signature*

Printed Name*

First Last

Date Signed*

MM slash DD slash YYYY

Another Child To Register?

If you answer "No" to the next question, you will be shown the fields needed complete your registration and make your payment. If you answer "Yes" then you will be returned to the top of the form so you can enroll the next child. Scroll down to the Child Information section, as the Parental Information section will be automatically pre-populated for you.

Do You Have Another Child To Register?*

Yes

VBS Registration Fee & Volunteer Discount

The VBS Camp Registration Fee is $50 per child. If you or another adult parent/guardian or immediate family member (age 18 or older) volunteers during the week, your children can attend for FREE each day are scheduled to volunteer.

Do you or another parent/guardian or sibling plan to volunteer for VBS?*

Yes

Select "Yes" to volunteer as a VBS assistant or group leader. You will be granted a 20% discount, for each day you volunteer. Volunteering for all 5 days will reduce your VBS registration cost to FREE!

Name*

First Name of Volunteer Last Name of Volunteer

Relationship to Student*

Parent, Guardian, Sibling (18 yrs or older)

Email*

The volunteer listed above would like to serve in the following role, if available:*

Please select the station(s) in which you would prefer to serve, as available:*

Crafts

Games

Bible Stories

Snack

Music

4th-5th Grade Crafts/Service Projects

Please select the age group(s) that you would prefer to assist, as available:*

Pre-K

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th and 5th Grade

The volunteer listed above will serve on the following days:*

Monday, June 22

Tuesday, June 23

Wednesday, June 24

Thursday, June 25

Friday, June 26

Number of Volunteer Days

Volunteer Confirmation*

I agree to the terms listed below

By agreeing, I confirm that I will be present to serve as a volunteer on the date(s) listed above. Should circumstances prevent me from volunteering, I will notify pastordonald@ilcp.org. I understand that, in my absence, I will not be eligible for the volunteer discount on the date of my absence, and I may be billed the additional fee for my student’s VBS attendance.

Total Number of Children Being Registered*

One Child

Two Children

Three Children

Four Children

Five Children

Total VBS 2026 Enrollment Fee*

Price: $0.00