Adaptive VBS Registration Form

Adaptive VBS Registration Form - 2026

Register your child for Adaptive Vacation Bible School (VBS) at Saint Brigid Catholic Church. Please complete all required sections below.
CAMPER REGISTRATION
Date: Tuesday, June 2nd to Thursday, June 4th, 2026
Time: 10am-12pm
Location: Saint Brigid Catholic Church

Please fill out the following form for each Camper you are registering individually.
Parent Information
Parent Name*
Parent Email Address*
example@example.com
Parent Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Child Information
Camper's Full Name*
Camper's Age*
Camper's T-Shirt Size (All Youth Sizes)*

SmallMediumLargeXL
Camper's Gender*

MaleFemale
Communication & Understanding
My Child communicates with others using (check all that apply):*

Full SentencesWords or PhrasesGesturesSign LanguageAn AAC Communication Device
My Child can understand what others are saying*

All of the TimeMost of the TimeSome of the Time
Does your Child use a wheelchair or special orthotics?*
Restroom Breaks
Please tell us about your child's toileting (check any that apply)*

uses the bathroom without assistanceis potty-trained but needs assistance to use the bathroomis currently potty-trainingwears training pants or diaper
How does your child indicate the need to use the bathroom?*
Medical & Feeding
Does your Child have any food allergies?*

YesNo
Please list any food allergies and/or restrictions below:*
Does your child carry an epi-pen?*

YesNo
Are there any feeding instructions we should know about?*
Does your child have a medical condition we need to be aware of?*
Behavior & Support
What is something that causes your child to be frustrated or upset:*
My child can be calmed by:*
These are some of my child's favorite things:*
Is there anything else you would like to tell us about your child that would help us to know him or her better?*
Media Policy
MEDIA POLICY: Saint Brigid uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels.

I have read and agree with the media policy.I hereby grant permission for Saint Brigid to use images and interviews of my child for internal or external communications.I do not grant permission for Saint Brigid to use images and interviews of my child for internal or external communications.
Should be Empty:

Adaptive VBS Registration Form - 2026

Parent Information

Child Information

Communication & Understanding

Restroom Breaks

Medical & Feeding

Behavior & Support

Media Policy