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Vacation Bible School

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- Child Registration Form
  
  Please fill out one form per child.
  
  The deadline to sign up is June 11, 2023.
  If wanting to register after June 11th, please email Shannon Fricker at [email protected].
- VBS registration is $20 per child, max $50 a family. After submitting your registration form, you will be provided with a link to make your payment online. If you are registering multiple children, please pay for them all with one payment.
  
  VBS is for 5-12 year olds. Children must be 5 by June 10th. Anyone age 13 or older can be a teen volunteer.
- CHILD'S INFORMATION:
- Name: REQUIRED Please fill out this field. Please enter valid data.
- Gender: REQUIRED Male Female Please fill out this field.
- Age at Time of VBS: REQUIRED Please fill out this field. Please enter valid data.
- Grade Completed: REQUIRED Please fill out this field. Please enter valid data.
- T-shirt Size: REQUIRED Child - S Child - M Child - L Adult - S Adult - M Adult - L Adult - XL Please fill out this field.
- Allergies or Medical Conditions: REQUIRED Please fill out this field. Please enter valid data.
- FAMILY INFORMATION:
- Parent / Guardian Name: REQUIRED Please fill out this field. Please enter valid data.
- Address: REQUIRED Please fill out this field. Please enter valid data.
- Email: REQUIRED Please fill out this field. Please enter an email address.
- Home Phone Number: Maximum 20 characters Please enter a phone number.
- Cell Phone Number: REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Emergency Contact Name: REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone Number: REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- I understand that reasonable precautions will be taken to safeguard the health and well being of the participants in this VBS and that I will be notified as soon as possible in the event of an emergency. In the case of sickness or an accident, I authorize and consent the VBS Team, or other associated volunteers of the VBS program to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that myself or other legal guardian(s) cannot be reached. I hereby do release and forever discharge Cat.Chat Productions, this Diocese, and Parish from all manners of actions, claims which I or the child named above shall or may have for any reason, arising during my child’s attendance of the VBS. Unless other written instruction is submitted, I also consent to allowing my child’s image to be recorded, either by photograph or video, and used during the VBS week or for future advertisement of VBS programs. Any other use will require your further consent.
- Parent / Guardian Signature: REQUIRED
  Please type your name.
  Please fill out this field. Please enter valid data.
- Date: REQUIRED Please fill out this field. Please enter a date.
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- Parish Ministries

Holy Rosary Catholic Church

La Chiesa del Santo Rosario

Vacation Bible School

Child Registration Form

CHILD'S INFORMATION:

FAMILY INFORMATION: