VBS Summer 2026 Registration Form

Add a Child

Child Name:

First NameLast Name

Age

Grade Level

T-Shirt Size

Does your child have any allergies or medical conditions?

Allergies / Medical Conditions

Health Insurance #

Would you like to add a 2nd child?

Child #2 Name:

First NameLast Name

Age of child #2

Grade Level of child #2

T-Shirt Size of child #2

Does your child #2 have any allergies or medical conditions?

Allergies / Medical Conditions for child #2

Health Insurance # for child #2

Would you like to add a 3rd child?

Child #3 Name:

First NameLast Name

Age of child #3

Grade Level of child #3

T-Shirt Size of child #3

Does your child #3 have any allergies or medical conditions?

Allergies / Medical Conditions of child #3

Health Insurance # of child #3

Parent / Guardian Name

Address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Name

Emergency Contact Phone

Please enter a valid phone number.Format: (000) 000-0000.

Consent

I understand that reasonable precautions will be taken to safeguard the health and well being of the participants in this VBS and that I will be notified as soon as possible in the event of an emergency. In the case of sickness or an accident, I authorize and consent the VBS Team, or other associated volunteers of the VBS program to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that myself or other legal guardian(s) cannot be reached. I hereby do release and forever discharge this diocese, parish and Cat.Chat Productions Inc. from all manners of actions, claims which I or the child named above shall or may have for any reason, arising during my child’s attendance of the VBS. Unless other written instruction is submitted, I also consent to allowing my child’s image to be recorded, either by photograph or video, and used during the VBS week or for future advertisement of VBS programs. Any other use will require your further consent.

Parent / Guardian Signature

Date

VBS Summer 2026 Registration Form

Child Information

Medical

Medical

Medical

Parent / Guardian Info

Emergency Contact

Consent

Signature