St. Mary VBS summer 2023 registration 
Tuesday, July 18th- Friday, July 21st 
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Child #1 *
Child #1 grade for upcoming school year  *
Child #1 t-shirt size *
Child #1 allergies *
Child # 2 Name
Child #2 grade for upcoming school year 
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Child #2 t-shirt size
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Child #2 allergies
Child #3 Name
Child #3 grade for upcoming school year 
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Child #3 t-shirt size
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Child #3 allergies
Parent Name *
Parent Email  *
Parent Cell Phone Number  *
Family Dentist Name and Number *
Family Doctor Name and Number *
CONSENT TO TREAT
I  authorize my child(ren) listed to receive medical treatment if required in an emergency. 
 *
I authorize VBS photos that may include my child(ren) to be displayed digitally or in hard copy. *
Accommodations needed in order to meet the needs of my child(ren)- please specify. *
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