Cost- $20
Discount available for families with three or more children. Payment can be made below. Space is limited. Registration opens 5/25.
Number of children registering for St Matthias VBS 2022
*
You may register up to 3 children from a single household using this form.
Child 1
Child 1 Information
Child's Name
*
First Name
Last Name
Child's Gender
*
Male
Female
Birthdate
*
-
Month
-
Day
Year
Medical information including allergies (Type N/A if not applicable)
*
Child 2
Child 2 Information
Child's Name
*
First Name
Last Name
Child's Gender
*
Male
Female
Birthdate
*
-
Month
-
Day
Year
Medical information including allergies (Type N/A if not applicable)
*
Child 3
Child 3 Information
Child's Name
*
First Name
Last Name
Child's Gender
*
Male
Female
Birthdate
*
-
Month
-
Day
Year
Medical information including allergies (Type N/A if not applicable)
*
Parent/Guardians 1 Name
*
First Name
Last Name
Parent/Guardians 2 Name
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Cell or Home Number
*
-
Area Code
Phone Number
Work Number
-
Area Code
Phone Number
E-mail
*
example@example.com
Emergency Contact: if parent cannot be reached
*
First Name
Last Name
Emergency Contact Number
*
Phone number including area code
People other than parent listed above who is allowed to pick up your child after dismissal.
Connection to St Matthias
Regular Attender
Visitor (Registration begins 5/25)
Anything you would like us to know?
Pictures are a great way to remember special, fun and significant moments. I give St Matthias permission to take pictures or video of my child/children for crafts, church displays and program celebration videos presented at VBS or/and on the Church Website.
*
Yes, I do give permission for my child's photo/video to be taken.
No, I do not give permission for my child's photo/video to be taken.
Please Sign Below
Submit
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