Sacred Heart Parish Vacation Bible School Registration Form 2017
Dates: Sunday, June 25th thru Thursday, June 29th
Time: 9:30am - 11:30am
Location: Sacred Heart Gym
Cost: 1 Child - $55, 2 or more Children $100.00
If you are paying online with a credit card, please add $5 to your total for it's use.
Child's First Name
Your answer
Child's Last Name
Your answer
Child's Gender
Child's Age
Date of Birth
MM
/
DD
/
YYYY
Last Completed School Grade
Mother's Name
Your answer
Father's Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Contact Phone Number
Your answer
Contact Email Address
Your answer
Home Parish
Your answer
Please list any Allergies
Your answer
Please list any Dietary Needs
Your answer
Other Medical Conditions
Your answer
In case of an emergency contact/Relationship to child
Your answer
Submit
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