VBS Registration Form Vacation Bible School 2023 Vacation Bible School 2023 Parent Name * Address * Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Home Phone * Work Phone * Cell Phone * E-mail * Names of Children Attending Name * Birth Date * Grade Just Completed * Pre-K 4 Kindergarten 1st 2nd 3rd 4th 5th Add Remove Emergency Contacts Name * Phone * Add Remove Permission to transport child to emergency room and/or doctor: * Yes No If "No", please advise us of your wishes: Photo Consent: As a parent/guardian, I understand that pictures may be taken during this event. I give permission for my son/daughter's picture to be taken and used for publication in the church bulletin, in PowerPoint presentations, church slideshows, on bulletin boards, on our website and in local papers. * Yes No Name of Person(s) picking up your child(ren) at 12:00 PM each day * Add Remove Tuition Registration fee is $35.00 per child (includes snack and program materials.) Cash Payments must be returned to the Parish office Monday-Thursday from 9:00 AM - 4:00 PM. Checks must be made payable to St. James VBS and deposited in the drop box outside the Parish office. Please write in the memo section of the check "for VBS" with your child's name. ***Online Payments will not be utilized this year.*** Parents Signature * Date * If you are human, leave this field blank. Submit
