VBS-Vacation Bible School

- Get Involved

July 6, 2015-July 10, 2015
9a.m til NOON

VBS 2015-"Weird Animals" Registration Form
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- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- City REQUIRED Please fill out this field. Please enter valid data.
  
  State REQUIRED Please fill out this field.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
- Email REQUIRED Please fill out this field. Please enter an email address.
- Home Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Cell Phone Number Please enter a phone number.
- Children Attending
  
  First (or only) Child Name REQUIRED
  Please add your child's name
  Please fill out this field. Please enter valid data.
  
  Grade just finished for the first child REQUIRED
  Please select the grade level of the first child.
  Please fill out this field.
  
  Second Child Name
  Please add your child name
  Please enter valid data.
  
  Grade just finished for second child
  Please select the grade level of the second child.
  
  Third Child Name
  Please add your child's name
  Please enter valid data.
  
  Grade just finished for third child
  Please select the grade level of the third child.
  
  Fourth Child Name
  Please add your child's name
  Please enter valid data.
  
  Grade just finished for fourth child
  Please select the grade level of the fourth child.
  
  Fifth Child Name
  Please add your child's name
  Please enter valid data.
  
  Grade just finished for fifth child
  Please select the grade level of the fifth child.
- Number of family members participating in VBS REQUIRED Please fill out this field. Please enter an integer (number).
- In Case Of Emergency, contact:
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Phone Number REQUIRED Please fill out this field. Please enter a phone number.
- Allergies or other medical conditions REQUIRED
  Please list all medical and allergy concerns for your child(ren). If none exists please put 'N/A'.
  Please fill out this field.
- Would you like to help? REQUIRED Yes I would! Please contact me using my cell. Yes I would! Please contact me using my home number. No Please fill out this field.
- Are you VIRTUS Trained? Yes I am! I am not VIRTUS trained.
Submit

St. Jude the Apostle

Catholic Church

VBS-Vacation Bible School

VBS 2015-"Weird Animals" Registration Form