VBS Registration Form

St. Joseph Vacation Bible School July 18-22, 2022

Learn stories of water from the Bible, and explore one of God's natural wonders.
Camper Name
Last Name *
First Name *
Middle Name
Gender *

Male Female
Camper's Information
Address *
City *
State *
Zip *
Home Phone *

Area Code Phone Number
Birth Date *

Month Day Year
Grade entering in the fall *
Parent or Legal Guardian Information
Parent/Legal Guardian *
Work Phone *

Area Code Phone Number
Cell Phone

Area Code Phone Number
Parent /Legal Guardian 2
Work Phone 2

Area Code Phone Number
Cell Phone 2

Area Code Phone Number
Parents Email *
Emergency Contact Name(if parent or guardian is not avaliable) *
Emergency Number *

Area Code Phone Number
Emergency Number #2

Area Code Phone Number
Does your child have any medical needs we need to be aware of? *

Yes No
Does your child have any social or learning needs we need to be aware of? *

Yes No
Does your child have any dietary restriction? *

Yes No
If you answered yes to any of the above, please explain
Church Information
Church you attend
Church City
Payment & Donation Information

There is no required cost for VBS. However, we would appreciate any donations you are able to give. Our program runs about $25 per child. If you would like to make a donation, you can bring it to the church office or faith formation office anytime during regular hours, or you can bring it any day during VBS. Please put it in an envelope with VBS Donation written on the front. We will also be asking for snack and craft item donations. We would appreciate any help you can give so we can continue to make this program free.
By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18.

I certify that my child has my permission to attend Vacation Bible School and participate in all activites.
Electronic signature, please initial *
I authorize St. Joseph Catholic Church to use my camper's picture, and video in any promotional material (web,print,or media)

Yes No
Electronic signature, please initial *
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St. Joseph Vacation Bible School July 18-22, 2022

Camper Name

Camper's Information

Parent or Legal Guardian Information

Church Information

Payment & Donation Information