VBS Registration 2022
Please complete this registration for Divine Mercy and consider helping us with a donation of food or $10
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Parent/Guardian name(s) *
Parent/Guardian primary phone number *
Parent/Guardian email address *
Child #1 name *
Child #1 grade level in the fall *
Child #1 allergies or medical information
Child #2 name
Child #2 grade level in the fall
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Child #2 allergies or medical information
Child #3 name
Child #3 grade level in the fall
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Child #3 allergies or medical information
Child #4 name
Child #4 grade level in the fall
Clear selection
Child #4 allergies or medical information
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