VBS Registration
2024
Welcome to the Vacation Bible School (VBS) Registration page.
June 3-7, 2024
9:00 am - 12:30 pm
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Family Information
On this page please enter information for your family. Parent 1 information must be completed. If you are 2 parent household please complete Parent 2 information.
Family Name
*
Parent 1 Name
*
First Name
Last Name
Parent 1 E-mail
*
Parent 1 Cell
*
-
Area Code
Phone Number
Parent 2 Name
First Name
Last Name
Parent 2 Email
Parent 2 Cell
-
Area Code
Phone Number
Family Primary Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
My Child (ren) attend
*
St. Alban Roe School
St. Alban Roe PSR
Other
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Cell Phone
*
-
Area Code
Phone Number
Emergency Contact Alternative Phone Number
*
-
Area Code
Phone Number
Hospital of Choice
*
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Child 1 Information
Use this page to enter information for your child
Child 1 Full Name
*
First Name
Last Name
Child 1 Birthdate
*
/
Month
/
Day
Year
Date Picker Icon
Child 1 Grade for 2024-2025
*
3 Year old
4 Year old
Pre K
Kindergarden
1st
2nd
3rd
4th
5th
6th
T-Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult X-Large
Does your Child 1 have any allergies we need to know about
*
Yes
No
Child 1 - Allergies
Do you need to add a 2nd child?
*
Yes
No
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Child Information #2
Use this page to enter information for a 2nd child
Child 2 Name
*
First Name
Last Name
Child 2 Birthdate
*
-
Month
-
Day
Year
Date Picker Icon
Child 2 Grade for 2024-2025
*
3 Year old
4 Year old
Pre K
Kindergarden
1st
2nd
3rd
4th
5th
6th
T-shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult X-Large
Does your Child 2 have any allergies we need to know about
*
Yes
No
Child 2 Allergies
Do you need to add a 3rd Child?
*
Yes
No
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Child 3 Information
Use this page to enter information for a 3rd child
Child 3 Name
*
First Name
Last Name
Child 3 Birthdate
*
-
Month
-
Day
Year
Date Picker Icon
Child 3 grade for 2024-2025
*
3 Year old
4 Year old
Pre K
Kindergarden
1st
2nd
3rd
4th
5th
6th
T-Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult X-Large
Does your Child 3 have any allergies we need to know about
*
Yes
No
Child 3 Allergies
Do you need to add a 4th child
Yes
No
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Child 4 Information
Use this page to enter information for a 4th child
Child 4 Name
*
First Name
Last Name
Child 4 Birthdate
*
-
Month
-
Day
Year
Date Picker Icon
Child 4 Grade for 2024-2025
*
3 Year old
4 Year old
Pre K
Kindergarden
1st
2nd
3rd
4th
5th
6th
T-Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult X-Large
Does your Child 4 have any allergies we need to know about
*
Yes
No
Child 4 - Allergies
Tell us about the allergies
Do you need to add a 5th Child
Yes
No
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Child 5
Use this page to enter information for a 5th child
Child 5 Name
*
First Name
Last Name
Child 5 Birthdate
*
-
Month
-
Day
Year
Date Picker Icon
Child 5 Grade for 2024-2025
*
3 Year old
4 Year old
Pre K
Kindergarden
1st
2nd
3rd
4th
5th
6th
T-Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult X-Large
Does your Child 5 have any allergies we need to know about
*
Yes
No
Child 5 - Allergies
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I would like to Volunteer
*
Yes
No
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Name
First Name
Last Name
Cell Phone Number
-
Area Code
Phone Number
Email
example@example.com
Have you completed Safe Environment Requirements?
Protecting Gods Children
Prevent and Protect
No
Emergency Contact
First Name
Last Name
Emergency Contact Cell phone
-
Area Code
Phone Number
T-Shirt size
Youth Small
Youth Medium
Youth Large
Adult Extra Small
Adult Small
Adult Medium
Adult Large
Adult X-Large
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Choose the total number of children you are registering for VBS. **There is a $5 Credit Card Processing fee per family.
*
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( X )
Number of children registering $55 each
$
55.00
Quantity
1
2
3
4
5
Item subtotal:
$
0.00
Credit Card Processing Fee - Non Refundable
$
5.00
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
Should be Empty: