VBS 2019 Registration
St. Mary's Catholic Church
1518 Parker St.
North Little Rock, AR 72114
Phone: (501) 374-5237
July 15th - July 19th
9:00 am - 12:00 pm
For children Grades K -5th
Date of Birth:
Last grade completed in school:
Name of parent(s):
Medical conditions/ concerns:
Emergency contact phone:
Relationship to child:
Siblings attending VBS (names and ages)
I hereby grant VBS leaders permission to photograph/ film the minor(s) designated above in any manner or form for any lawful purpose associated with this VBS program.
For Questions or Concerns please contact Angela Owen,
Each child needs to be registered separately.
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