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VBS 2023 - July 10-14 from 9am to noon
For Children age 4 years to 5th Grade
Registration Fee: $75.00 per child
Adult/Teen Family Crew Leaders - No Fee
NO refunds will be given after June 1st.
Are you a Parishioner?
Yes
No
Non Parishioners can register beginning Monday 03/29/2022
Todays Date
How many children are you registering today? (1-4)
There are only a total of 120 spots for this year.
Spots Left: 0
Adult/Teen Family crew leader T-shirt size
adult small
adult medium
adult large
adult extra large
Child 1
Participant’s Name
Sex
Male
Female
Date of Birth
Grade entering in September
Preschool
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
T-Shirt size
Child X-Small (2-4)
Child Small (6-8)
Child Medium (10-12)
Child Large (14-16)
Child X-Large (18-20)
Please select music option
CD
Downloadable Code for 1 device
Child 2
Participant’s Name
Sex
Male
Female
Date of Birth
Grade entering in September
Preschool
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
T-Shirt size
Child X-Small (2-4)
Child Small (6-8)
Child Medium (10-12)
Child Large (14-16)
Child X-Large (18-20)
Please select music option
CD
Downloadable Code for 1 device
Child 3
Participant’s Name
Sex
Male
Female
Date of Birth
Grade entering in September
Preschool
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
T-Shirt size
Child X-Small (2-4)
Child Small (6-8)
Child Medium (10-12)
Child Large (14-16)
Child X-Large (18-20)
Please select music option
CD
Downloadable Code for 1 device
Child 4
Participant’s Name
Sex
Male
Female
Date of Birth
Grade entering in September
Preschool
Kindergarten
First Grade
Second Grade
Third Grade
Fourth Grade
Fifth Grade
T-Shirt size
Child X-Small (2-4)
Child Small (6-8)
Child Medium (10-12)
Child Large (14-16)
Child X-Large (18-20)
Please select music option
CD
Downloadable Code for 1 device
Page Break
Parent
Parent / Guardian
Parish
E-mail
Home Phone
Cell Phone
Work Phone
Emergency Contact Information
Allergies / Epipen? or Special Needs
Person responsible for picking up child at the end of each VBS day:
Name
Phone
Parent / Guardian signature
Clear
I also consent to the use of any videotapes and/or photographs in which my child may appear by the Diocese of Trenton and/or the parish. I understand that these materials are being used for promotion of the parish Religious Education programs and/or activities, which may include recruitment and fundraising efforts. Students names will not be included with any photograph.
Yes
No
I have a credit from last years vbs registration
Yes
No
Please Note: Payment is due at time of registration
Total Amount
Verification
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