Vacation Bible School Registration&lt;span&gt; IS CLOSED AS OF JULY 15, 2022&lt;/span&gt;

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Today's Date REQUIRED Please fill out this field. Please enter a date.
Home Parish REQUIRED Please fill out this field. Please enter valid data.
Section for Parent/Guardian Information
Family Last Name REQUIRED Please fill out this field. Please enter valid data.
Father's Name
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.
Mother's name
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email REQUIRED Please fill out this field. Please enter an email address.
Emergency Contact #1
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Emergency Contact #2
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Name of person that will pick child up from VBS
First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
- You can enter more than 1 child on this form. Please enter the number of children you wish to register. There is a reduced price if you have more than 1 child. REQUIRED Please fill out this field.
- Child 1
  - Child's name REQUIRED Please fill out this field. Please enter valid data.
  - Birth Date REQUIRED Please fill out this field. Please enter a date.
  - Age REQUIRED Please fill out this field. Please enter an integer (number).
  - Sex REQUIRED Female Male Please fill out this field.
  - Last Grade Completed REQUIRED Please fill out this field. Please enter an integer (number).
  - Does your child have special needs/allergies or a medical condition? REQUIRED Yes No Please fill out this field.
  - If Yes, please provide more detail and/or medical information Please enter valid data.
- Child 2
  - Child's name REQUIRED Please fill out this field. Please enter valid data.
  - Birth Date REQUIRED Please fill out this field. Please enter a date.
  - Age REQUIRED Please fill out this field. Please enter an integer (number).
  - Sex REQUIRED Female Male Please fill out this field.
  - Last Grade Completed REQUIRED Please fill out this field. Please enter an integer (number).
  - Does your child have special needs/allergies or a medical condition? REQUIRED Yes No Please fill out this field.
  - If Yes, please provide more detail and/or medical information Please enter valid data.
- Child 3
  - Child's name REQUIRED Please fill out this field. Please enter valid data.
  - Birth Date REQUIRED Please fill out this field. Please enter a date.
  - Age REQUIRED Please fill out this field. Please enter an integer (number).
  - Sex REQUIRED Female Male Please fill out this field.
  - Last Grade Completed REQUIRED Please fill out this field. Please enter an integer (number).
  - Does your child have special needs/allergies or a medical condition? REQUIRED Yes No Please fill out this field.
  - If Yes, please provide more detail and/or medical information Please enter valid data.
- Child 4
  - Child's name REQUIRED Please fill out this field. Please enter valid data.
  - Birth Date REQUIRED Please fill out this field. Please enter a date.
  - Age REQUIRED Please fill out this field. Please enter an integer (number).
  - Sex REQUIRED Female Male Please fill out this field.
  - Last Grade Completed REQUIRED Please fill out this field. Please enter an integer (number).
  - Does your child have special needs/allergies or a medical condition? REQUIRED Yes No Please fill out this field.
  - If Yes, please provide more detail and/or medical information Please enter valid data.
- Child 5
  - Child's name REQUIRED Please fill out this field. Please enter valid data.
  - Birth Date REQUIRED Please fill out this field. Please enter a date.
  - Age REQUIRED Please fill out this field. Please enter an integer (number).
  - Sex REQUIRED Female Male Please fill out this field.
  - Last Grade Completed REQUIRED Please fill out this field. Please enter an integer (number).
  - Does your child have special needs/allergies or a medical condition? REQUIRED Yes No Please fill out this field.
  - If Yes, please provide more detail and/or medical information Please enter valid data.
St Matthew the Apostle Church/VBS has my permission to use my child's photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. No names of children will be used in any photograph captions.
Please choose Yes or No REQUIRED
St Matthew the Apostle Church/VBS has my permission to use my child's photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. No names of children will be used in any photograph captions.
Yes No Please fill out this field.
Registered Parishioner Tuition REQUIRED Please fill out this field.

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Vacation Bible School Registration IS CLOSED AS OF JULY 15, 2022