2021 IN PERSON Vacation Bible School at Resurrection Parish
Where Kids Stand Strong for God
Children entering K-Gr 5 as of Sep '21.
August 9-13, 2021 from 9:30 - 11:30am
Please complete one form per child.
Child's Name
*
First Name
Last Name
Child First Name
*
Child Last Name
*
Gender
*
Male
Female
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Grade entering in SEP 2021
*
Please Select
Kindergarten
1st
2nd
3rd
4th
5th
Campers are Grades K-5
Parish
*
Resurrection
St. Matthew's
Primary Parent Full Name
*
Secondary Parent Full Name
Primary Parent cell
*
Please enter a valid phone number.
Secondary Parent cell
Please enter a valid phone number.
Primary email contact
*
Confirmation Email
Confirm email
Please contact
Full name
*
,
relationship
*
if a parent is unreachable in an emergency. He/she can be reached at
Phone Number
*
.
Please list any allergies or required medication?
*
None
EMERGENCY MEDICAL CONSENT FORM
I,
{primaryParent}
, parent/guardian of,
{childsName11}
request Resurrection Parish, 651 Millbrook Ave, Randolph, NJ 07869, to accept my child into its Vacation Bible School.
Signer's Full Name
*
WEBSITE PHOTO/VIDEO WAIVER
I,
{primaryParent}
, parent/guardian of,
{childsName11}
give my permission for the posting of photos or video on the Resurrection Parish Website that may contain my son/daughter.
Signer's Full Name
*
Do you want to register another camper (Grades K-5)?
*
YES
NO
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