2023 VBS Registration Form

Please Fill Out One Form Per Child
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Child's Name *
Child's Age
 *
Child's DOB
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Grade in 2022/2023
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Child's Shirt Size

**Please Note We Are Asking  For A $2 Good Will Donation For Supplies**
Parent Name
Parent Phone #
Parent Email
 *
Emergency Contact Name
Emergency Contact Relationship
Address
Allergies and/or Medical Conditions
Insurance Information ( Company and Policy 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 from 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 further consent.

Please Type First Name Last Name and Middle Initial Below

Physical Copy May Need Signed At Check-in Day 1
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