Vacation Bible School Registration
Please register your child for summer vacation Bible School June 10-13 from 9 AM until 12 PM at St. Francis in Brussels. This form will also be used for volunteers.

Registration is due May 15, 2019

Name of child or volunteer *
Your answer
Grade your child completed this year (or choose adult volunteer) *
Male or female *
Allergies, medications, or special needs. Write N/A if none needed. *
Your answer
Parent or Guardian Name
Your answer
Parent or Guardian Phone Number
Your answer
Parent or Guardian Address
Your answer
School Attending
Your answer
Home parish *
Your answer
Please sign up registrant as *
If you are an adult volunteer, are you VIRTUS trained?
Do we have permission to share your child's picture for future fliers or church communication? *
Please list any dates your child will not be in attendance or if you are a volunteer, which dates you cannot be there.
Your answer
Checking this Box Gives Medical Consent: In the event that parent/guardian cannot be reached I give permission to the VBS director to seek necessary treatment. Parent/Guardian will assume responsibility for all medical bills. *
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