2017 Vacation Bible School
Registration for Sacred Heart V.B.S. 2017
Email address
Mother's Name
Your answer
Father's Name
Your answer
Address:
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Home Telephone
Your answer
Cell Phone
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1) First Child's Name
Your answer
First Child's Age and Grade
Your answer
First Child's Allergies
Your answer
2) Second Child's Name
Your answer
Second Child's Age and Grade
Your answer
Second Child's Allergies
Your answer
3) Third Child's Name
Your answer
Third Child's Age and Grade
Your answer
Third Child's Allergies
Your answer
1st Emergency Contact Name (Other than parent)
Your answer
1st Emergency Contact Phone (Other than parent)
Your answer
2nd Emergency Contact Name (Other than parent)
Your answer
2nd Emergency Contact Phone (Other than parent)
Your answer
Photograph Permission: Do you give your child (ren) permission to be in pictures taken during V.B.S. activities and displayed at Church of the Sacred Heart, bulletin, Facebook, or possibly local newspapers?
Listing Permission: Do you give permission for your child's name to be listed at Church of the Sacred Heart, the cluster bulletin, Facebook, or possibly local newspapers?
Acknowledgement: I understand that I am enrolling my child (ren) in the V.B.S. program at Sacred Heart for the week of July 11th-15th, 217.
Parent Signature
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Date
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