2019 VBS STUDENT Registration

Please use this form to register STUDENTS for Vacation Bible School June 17-21, 2019.

If you would like to register to be a VOLUNTEER please use the form at this link.
https://web4u.forms-db.com/edit_form.php?id=220857

Should you have specific questions or concerns, please email: ststephenvbs@yahoo.com.

Parent Name Parent Name First Last
cell phone cell phone - ### - ### ####
Email
Second Parent's name Second Parent's name First Last
cell phone cell phone - ### - ### ####
In the event of an emergency, if we cannot reach you, who should we contact? In the event of an emergency, if we cannot reach you, who should we contact? First Last
Phone Phone - ### - ### ####
Are you members of St. Stephen Catholic Community? (Membership not required for registration.)

Are you members of St. Stephen Catholic Community? (Membership not required for registration.) yes no
How many children are you registering?
Child 1 name Child 1 name First Last
Child 1 date of birth Child 1 date of birth / MM / DD YYYY
Child 1 age
Grade Child 1 will ENTER Fall of 2019.
*If your child is going into Kindergarten or PreK, please enter a 0 (zero).
Child 2 name Child 2 name First Last
Child 2 date of birth Child 2 date of birth / MM / DD YYYY
Child 2 age
Grade Child 2 will ENTER Fall of 2019.
*If your child is going into Kindergarten or PreK, please enter a 0 (zero).
Child 3 name Child 3 name First Last
Child 3 date of birth Child 3 date of birth / MM / DD YYYY
Child 3 age
Grade Child 3 will ENTER Fall of 2019.
*If your child is going into Kindergarten or PreK, please enter a 0 (zero).
Child 4 name Child 4 name First Last
Child 4 date of birth Child 4 date of birth / MM / DD YYYY
Child 4 age
Grade Child 4 will ENTER Fall of 2019.
*If your child is going into Kindergarten or PreK, please enter a 0 (zero).
Child 5 name Child 5 name First Last
Child 5 date of birth Child 5 date of birth / MM / DD YYYY
Child 5 age
Grade Child 5 will ENTER Fall of 2019.
*If your child is going into Kindergarten or PreK, please enter a 0 (zero).
Child 6 name Child 6 name First Last
Child 6 date of birth Child 6 date of birth / MM / DD YYYY
Child 6 age
Grade Child 6 will ENTER Fall of 2019.
*If your child is going into Kindergarten or PreK, please enter a 0 (zero).
Do any of your children have allergies?

Do any of your children have allergies? yes no
Please list the name(s), the allergies, and reaction.
Do you have a child with special needs?

Do you have a child with special needs? yes no
Please list the name(s) and what special assistance is needed.
I grant permission to St. Stephen Catholic Community to post my child's(ren's) image to the St. Stephen Catholic Community Website, Facebook, Parish App and other parish publications.

I grant permission to St. Stephen Catholic Community to post my child's(ren's) image to the St. Stephen Catholic Community Website, Facebook, Parish App and other parish publications. yes no
Donation: St. Stephen VBS is free to all participants. However, we do take monetary donations for supplies and snacks. $ Dollars . Cents