Parent/Guardian Info
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Name
First Name
Last Name
Email
*
example@example.com
Best Daytime Phone
*
Backup Phone
*
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Child 1
Name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
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Grade (Fall 2018)
*
K
1
2
3
4
5
T-shirt Size
*
YXS
YS
YM
YL
YXL
Allergies, Medication Instruction, Special Needs
Register Another Child?
*
Yes
No
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Child 2
Name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
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Grade (Fall 2018)
*
K
1
2
3
4
5
T-shirt Size
*
YXS
YS
YM
YL
YXL
Allegies, Medication Instructions, Special Needs:
Register Another Child?
Yes
No
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Child 3
Name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
Date Picker Icon
Grade (Fall 2018)
*
K
1
2
3
4
5
T-shirt Size
*
YXS
YS
YM
YL
YXL
Allegies, Medication Instructions, Special Needs:
Register Another Child
Yes
No
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Child 4
Name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
Date Picker Icon
Grade (Fall 2018)
*
K
1
2
3
4
5
T-shirt Size
*
YXS
YS
YM
YL
YXL
Allergies, Medication Instructions, Special Needs:
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Legal
I give full permission for my child(ren) to attend Vacation Bible Camp sponsored by Church of St. Paul & the Redeemer. I agree to hold the Diocese of Chicago and Church of St. Paul & the Redeemer and any associated agencies and persons free of liability and waive any claims for payment for accident, injury, disability, or damages to the person or property of the aforementioned child(ren) arising out of or connected with his/her participation in any activity related to Vacation Bible Camp 2018. I give permission for photos taken of my child(ren) to be used for church-related communications. I give permission to leaders of Vacation Bible Camp 2018 and staff of St. Paul & the Redeemer church to secure emergency medical or surgical treatment for my child(ren) and to secure routine medical care as needed if I am not present and there is insufficient time to contact me.
*
I agree
Full Legal Name
*
Today's Date
*
-
Month
-
Day
Year
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Fees
The registration fee is $35 per child. (If you need a scholarship, contact Monte Tugwete: tugwete@sprchicago.org).
Payment Options
You can either pay in-PersonPay on the first day of camp using cash, check, or credit card OR mail a CheckMail a check payable to SPR and put "VBC" in the memo line. Mail to 4945 S Dorchester Ave, Chicago IL 60615.
Submit Registration
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