VBS Registration

REGISTRATION OPENS- MAY 14, 2023

LAST DAY TO REGISTER- JULY 1, 2023
Cost- $25

Discount available for families with three or more children. Payment can be made below. Space is limited. Registration opens 5/14/23 and closes 6/1/23.
Number of children registering for St Matthias VBS 2023*
You may register up to 3 children from a single household using this form.

Child 1
Child 1 Information
Child's Name*

First NameLast Name
Birthdate*

MonthDayYear
Child's Gender*
Child's T-Shirt Size*
Included in registration cost
Medical information including allergies (Type N/A if not applicable)*

Child 2
Child 2 Information
Child's Name*

First NameLast Name
Birthdate*

MonthDayYear
Child's Gender*
Child's T-Shirt Size*
Included in registration cost
Medical information including allergies (Type N/A if not applicable)*

Child 3
Child 3 Information
Child's Name*

First NameLast Name
Birthdate*

MonthDayYear
Child's Gender*
Child's T-Shirt Size*
Included in registration cost
Medical information including allergies (Type N/A if not applicable)*

Parent Information
Parent/Guardians 1 Name*

First NameLast Name
Parent/Guardians 2 Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 1 Cell or Home Number*

Area CodePhone Number
Parent 2 Cell or Home Number

Area CodePhone Number
Work Number

Area CodePhone Number
E-mail*
example@example.com
Emergency Contact: if parents cannot be reached*

First NameLast 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
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.
As the parent or legal guardian of my child/children, I acknowledge that I have read and understand the Parent Consent & Liability Release information, and hereby give consent for my child to attend and participate in the St Matthias 2023 VBS program.

I also understand that registration is not complete until payment has been made online at the PayPal link on the next page for:

1 Child- $25

2 Children - $50

3 Children - $65
Please Sign Below

Clear
Should be Empty:

Cost- $25

Child 1 Information

Child 2 Information

Child 3 Information

Parent Information