2018 Vacation Bible School Child Registration

July 23-27, 2018

 

Registration for Vacation Bible School (VBS) is now open to children, from all parishes and Christian churches, age 4 years old (by June 30th) through students entering 5th Grade in the Fall of 2018.  Content of VBS is centered on Jesus Christ and includes Catholic content on the sacrements, saints, prayers, and the Mass.

Each day of VBS will include:

  • Bible Lesson
  • Music
  • Story Time
  • Crafts
  • Outdoor Activities
  • Saint of the Day
  • Prayer Service

Each child will receive:

  • T-Shirt
  • Music CD
  • Catholic Family VBS Newsletter

Registration is $50.00 per child prior to June 30th.  Registrations received after June 30th will incur a $15.00 late fee per family.

 

 

Parent/Guardian Contact Information
Name
  •  
Address
  •  
Phone --
  •  
(Please provide the best number to be contacted with)
E-mail
  •  
(Please actively check your e-mail, as this will be the primary method of communicating important information about the program)
Student #1 Information
Name
  •  
Gender
  •  
Date of Birth //
  •  
Age
  •  
(As of June 30, 2018)
T-Shirt Size
  •  
T-shirts are 100% pre-shrunk cotton, but it is our experience that they run small.
Grade in the Fall of 2018
  •  
Medical Conditions
  •  
(Please list any known medical history information, such as allergies, dietary restrictions, ongoing conditions, etc.)
Student #2 Information
(Please be sure to fill in all required information boxes as completed for Student #1)
Name
  •  
Gender
  •  
Date of Birth //
  •  
Age
  •  
(As of June 30, 2018)
T-Shirt Size
  •  
T-shirts are 100% pre-shrunk cotton, but it is our experience that they run small.
Grade in the Fall of 2018
  •  
Medical Conditions
  •  
(Please list any known medical history information, such as allergies, dietary restrictions, ongoing conditions, etc.)
Student #3 Information
(Please be sure to fill in all required information boxes as completed for Student #1)
Name
  •  
Gender
  •  
Date of Birth //
  •  
Age
  •  
(As of June 30, 2018)
T-Shirt Size
  •  
T-shirts are 100% pre-shrunk cotton, but it is our experience that they run small.
Grade in the Fall of 2018
  •  
Medical Conditions
  •  
(Please list any known medical history information, such as allergies, dietary restrictions, ongoing conditions, etc.)
Emergency Contact Information
Name
  •  
Relationship
  •  
Phone --
  •  
Pick-up/Drop-Off Information
Name
  •  
Phone --
  •  
In case of an emergency, or if the designated person cannot be contacted to pick up my child, I hereby authorize the following person(s) to pick-up my child.
Name
  •  
Phone --
  •  
Relationship
  •  
Name
  •  
Phone --
  •  
Relationship
  •  
Payment Information
VBS Registration Fee  
Quantity Extended

Registration Fee | $50.00

  •  
Please make checks payable to "Saint Raphael Parish". On the memo line please write "VBS" and your child's name. Payment can be provided via mail or dropped off in the parish office.
Payment is due within seven business days of registration.
Parent Consent “By typing my name below, which shall constitute my electronic signature, I acknowledge that I am the parent or legal guardian of the above named Child(ren) and have the authority to sign this document and act on his/her or their behalf. I agree that my electronic signature is intended to authenticate this writing and to have the same force and effect as my manual signature. As the parent or legal guardian of the student(s) listed above, my signature constitutes my acknowledgement and agreement to all of the foregoing terms.” :
Parent/Guardian Signature
  •  
Spam Capture
  •