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
Grade your child completed this year (or choose adult volunteer)
6, 7 or 8 (volunteer)
(9, 10, 11, or 12, volunteer)
I am an adult volunteer
Male or female
Allergies, medications, or special needs. Write N/A if none needed.
Parent or Guardian Name
Parent or Guardian Phone Number
Parent or Guardian Address
Please sign up registrant as
Student (participant in grade K-5)
Helper (grade 6-12)
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.
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.
Check here for permission.
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