Vacation Bible School Registration 2019
Shipwrecked Rescued by Jesus
Submit one per child
June 24th - June 28th
9:30 am - 12:00 pm
4yrs old and up
Cost : Free
Presented by the Religious Education Program
Child Last Name *
Your answer
Child First Name *
Your answer
Age (as of June 1st 2019) *
Gender *
Grade just completed?
Your answer
Parent's Names *
First and Last Names (if different from the child)!
Your answer
Are you a registered parishioner?
Parent Numbers (Cell, Home, etc.) *
List them all here with area codes please!
Your answer
Parent Email Address *
Your answer
Home Address *
Mailing address for the child.
Your answer
Any medical issues we should be aware of?
Food allergies, special needs, etc.
Your answer
Emergency Contact Person (Name) *
Your answer
Emergency Contact Person Phone Number *
Your answer
Family Doctor Name *
Your answer
Family Doctor Phone Number *
Your answer
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