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Vacation Bible School Participant Registration
St. Mary of the Woods VBS: June 27th - July 1st, 2022
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* Indicates required question
Child #1 Name, Gender, Age, DOB, Last Grade Completed
*
Your answer
Child #2 Name, Gender, Age, DOB, Last Grade Completed
Your answer
Child #3 Name, Gender, Age, DOB, Last Grade Completed
Your answer
Child #4 Name, Gender, Age, DOB, Last Grade Completed
Your answer
Parent / Guardian Name
*
Your answer
Street Address, City, State, Zip Code
*
Your answer
Parent/Guardian's Cell Phone
*
Your answer
Daytime Caregiver's Name & Cell Phone *if different from previous question*
Your answer
Home Parish
Your answer
Allergies, Medical Conditions, or Special Needs
*
Your answer
Emergency Contact: Name
*
(If Parent/Guardian can't be reached)
Your answer
Emergency Contact: Cell Phone
*
(If Parent/Guardian can't be reached)
Your answer
Emergency Contact: Relationship to Child
*
(If Parent/Guardian can't be reached)
Your answer
Pictures of my child taken during VBS may be posted to Social Media and be used for promotional materials.
*
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Agreement of Authenticity
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By checking this box you are agreeing that the information in this form is correct.
Required
Parent/Guardian Signature
*
Your answer
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