Super Hero VBS Camp 2023

Ss Cosmas and Damian Super Hero VBS Camp

* Required Field
Parent/Guardian First Name*
Parent/Gurdian Last Name*
Parent/Guardian Email*
Best Phone*
Other Phone
Child First Name (1)*
Child Last Name (1)*
Gender (1)*

MaleFemale
Age (1)*
Last Grade Completed by 6/6/2022*

Pre-SchoolPre KK12345
Date of Birth (1)*

MonthDayYear
Date
T-Shirt Size (1)*

Youth SYouth MYouth LYouth XLAdult SAdult MAdult L
Allergies or other Medical Conditions (1)*
Dietary Restrictions (1)
Child First Name (2)
Child Last Name (2)
Gender (2)

MaleFemale
Age (2)
Last Grade Completed by 6/6/2022

Pre-SchoolPre KK12345
Date of Birth (2)

MonthDayYear
Date
T-Shirt Size (2)

Youth SYouth MYouth LYouth XLAdult SAdult MAdult L
Allergies or other Medical Conditions (2)
Dietary Restrictions (2)
Child First Name (3)
Child Last Name (3)
Gender (3)

MaleFemale
Age (3)
Last Grade Completed by 6/6/2022

Pre-SchoolPre KK12345
Date of Birth (3)

MonthDayYear
Date
T-Shirt Size (3)

Youth SYouth MYouth LYouth XLAdult SAdult MAdult L
Allergies or other Medical Conditions (3)
Dietary Restrictions (3)
Family Address*
City*
State*

OH
Zip*
Home Church
Emergency Contact*
Emergency Contact Phone*
Emergency Contact Relationship*
Comments
You have my permission and consent for my child to attend VBS, to participate in its activities, to receive emergency treatment if necessary and to allow photographs, videos, and interviews to be taken and published and used to illustrate, promote, and advertise activities at Ss. Cosmas and Damian Church. In signing below, I acknowledge that I have read and understand these instructions.
Signature Parent/Guardian*
The cost of VBS is $40 per child. This includes t-shirt, take-home items, snacks, and all materials needed for the day. You may pay online by credit card (a $2.50 service fee will be applied) or you may drop off a check, addressed to Ss. Cosmas and Damian Parish, at the Parish Office.

If you plan to pay by check, please be sure each product is unchecked below and click the submit button at the bottom of the page.
My Products
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VBS - 1 Child$42.50

VBS - 2 Children$82.50

VBS - 3 Children$102.50

Total $0.00
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Ss Cosmas and Damian Super Hero VBS Camp