Shipwrecked VBS Registration
Please complete this form to register your child for Shipwrecked VBS. VBS takes place from July 9-13, 2018 from 8:30-12:30 at St. Nicholas School and is open to all incoming Kindergarteners through incoming 5th graders.

The cost per child is $100; payment can be dropped off or mailed to the St. Nicholas Parish Office between the date of registration and the first day of camp. Checks should be made out to St. Nicholas Church.

If you have any questions, please email Melissa Geier at mgeier@dsj.org or Catherine Lammersen at cat.lammersen@hotmail.com. We look forward to having your child with us!

Student's First Name *
Your answer
Student's Last Name *
Your answer
Nickname (if applicable)
Your answer
Student's Incoming Grade (2018-2019) *
Student's Gender *
Address *
Your answer
Parent/Guardian #1 Name *
Your answer
Parent/Guardian #1 Relation *
Parent/Guardian #1 Email *
Your answer
Parent/Guardian #1 Phone *
Your answer
Parent/Guardian #2 Name
Your answer
Parent/Guardian #2 Relation
Parent/Guardian #2 Email
Your answer
Parent/Guardian #2 Phone
Your answer
Student T-Shirt Size (child sizes) *
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