Vacation Bible School 2024 Sign-Up | St. Michael the Archangel

Family Last Name*

Father's Name

First Last

Mother's Name

First Last

Mailing Address

Street Address Address Line 2 City State ZIP Code

Email*

Enter Email Confirm Email

Our primary form of communications is email. Please provide the address you check most often.

Add other email here if needed

Home Phone

Please include area code

Cell Phone*

Please include area code

Number of Children Registering

Student 1 Information

Child 1 Name

(First, Middle, Last, Suffix)

Child 1 Nickname

(if applicable)

Child 1 Date of Birth

(MM/DD/YYYY)

Child 1 Gender

Female

Male

Child 1 Grade (Fall 2024)

Kindergarten

First Grade

Second Grade

Third Grade

Fourth Grade

Child 1 Allergies (if any)

Child 1 Medications (if any)

Child 1 Special Conditions:

(Please mention anything that we should be aware of, i.e. dietary restrictions, behavioral or learning accommodations, etc.

It would be nice if my child is placed in the same group as:

Hidden

Student 2 Information

Child 2 Name

(First, Middle, Last, Suffix)

Child 2 Nickname

(if applicable)

Child 2 Date of Birth

(MM/DD/YYYY)

Child 2 Gender

Female

Male

Child 2 Grade (Fall 2024)

Kindergarten

First Grade

Second Grade

Third Grade

Fourth Grade

Child 2 Allergies (if any)

Child 2 Medications (if any)

Child 2 Special Conditions:

(Please mention anything that we should be aware of, i.e. dietary restrictions, behavioral or learning accommodations, etc.

It would be nice if my child is placed in the same group as:

Hidden

Student 3 Information

Child 3 Name

(First, Middle, Last, Suffix)

Child 3 Nickname

(if applicable)

Child 3 Date of Birth

(MM/DD/YYYY)

Child 3 Gender

Female

Male

Child 3 Grade (Fall 2024)

Kindergarten

First Grade

Second Grade

Third Grade

Fourth Grade

Child 3 Allergies (if any)

Child 3 Medications (if any)

Child 3 Special Conditions:

(Please mention anything that we should be aware of, i.e. dietary restrictions, behavioral or learning accommodations, etc.

It would be nice if my child is placed in the same group as:

Hidden

Student 4 Information

Child 4 Name

(First, Middle, Last, Suffix)

Child 4 Nickname

(if applicable)

Child 4 Date of Birth

(MM/DD/YYYY)

Child 4 Gender

Female

Male

Child 4 Grade (Fall 2024)

Kindergarten

First Grade

Second Grade

Third Grade

Fourth Grade

Child 4 Allergies (if any)

Child 4 Medications (if any)

Special Conditions:

(Please mention anything that we should be aware of, i.e. dietary restrictions, behavioral or learning accommodations, etc.

It would be nice if my child is placed in the same group as:

Emergency Contact Information

Emergency Contact Name*

(Other than Parents)

Relationship to child*

Emergency Contact Cell Phone*

Emergency Contact Home Phone

Alternate Pickup Name

(Other than Parents)

Alternate Pickup Cell Phone

Permission To Attend

I give permission for my child (named above) to attend the Vacation Bible School (VBS) listed above. I understand that the information I give for this registration will only be used by the VBS hosting church, and that all registration information will be removed from the hosting site by December 31 of this year.

Medical Release

I give my permission for the VBS staff to administer basic first aid to my child (children) (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency services will be paid by me.

Permission for Photography/Video Recording

I hereby grant the above named parish permission to copyright and use photographs/videos taken at VBS of the minor designated above in any manner or form for any purpose lawful at any time. I waive any right that I may have to inspect or approve the finished product or written copy, that may be used in conjunction therewith, or the use to which it may be applied.

Please respond below

I agree to the above conditions

I don’t agree to the above conditions

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