Vacation Bible School Form

July 15-19, 2019 | 9:00am – NOON

VPK – 5th Grade | Ages: 4 years old-11 years old

Cost: $20 per child (Donation for two or more siblings)

(ONE FORM PER FAMILY)

Name of Participant One: *
Name of Participant One:
Date of Birth: *
Date of Birth:
T-Shirt Size:
Name of Participant Two:
Name of Participant Two:
Date of Birth:
Date of Birth:
T-Shirt Size:
Name of Participant Three:
Name of Participant Three:
Date of Birth:
Date of Birth:
T-Shirt Size:
Name of Participant Four:
Name of Participant Four:
Date of Birth:
Date of Birth:
T-Shirt Size:
Home Address:
Home Address:
Parent's | Guardian's Name:
Parent's | Guardian's Name:
Phone Number:
Phone Number:
Work Number:
Work Number:
Would you like a Music CD for an additional $8.00?
Would you like a Music DVD for an additional $15.00?
Emergency Contact Information:
Name:
Name:
Phone:
Phone:
I give permission for St. Ann to use my child’s name and/or photo for promotional, news, or public relations purposes in print and/or electronic media.
Volunteer Opportunities:
If you choose to volunteer a minimum of THREE days, the registration fee will be waived.
Name:
Name:
I would like to volunteer to help with VBS in the following manner:
Please select only ONE option