St. Francis of Assisi Parish: VBS Participant Registration 2019
Thank you for your interest in St. Francis of Assisi's Vacation Bible School Program 2019!

THE PROGRAM IS OPEN TO STUDENTS ENTERING PRE-K - 6TH GRADE

VBS takes place:
Monday- Friday, June 17-28, 2019, 9:00am- 1:00pm

ONE FORM MUST BE FILLED OUT FOR EACH CHILD

REGISTRATION OPENS: Tuesday, March 5, 2019
REGISTRATION CLOSES: Friday, June 7, 2019

To COMPLETELY register, please do the following:

1. Complete this form in its entirety (ONE SUBMISSION PER PARTICIPANT)
2. Make a payment of $150/Participant via Paybee Link here or at the end of registration: paybee.io/@sfoasj@9
*Registration will not be complete until payment is received

For questions or concerns, please contact Kevin Bernaga at kbernaga@dsj.org

Email address *
VBS Theme 2019:
Participant's First Name *
Your answer
Participant's Last Name *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Last Grade Completed *
Shirt Size (Child)
Allergy/Medical Condition(s) ("N/A" if not applicable) *
Your answer
Father's Name/Guardian #1 *
Your answer
Father's/Guardian #1 Cell Phone # *
Your answer
Mother's Name/Guardian #2 *
Your answer
Mother's/Guardian #2 Cell Phone # *
Your answer
Family Address *
Your answer
Home Phone # *
Your answer
Emergency Contact Name (Other than Parent/Guardian) *
Your answer
Emergency Contact Relation (i.e Aunt, Uncle, Godparent, etc) *
Your answer
Emergency Contact Phone # *
Your answer
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