VBS Registration

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Parent Name REQUIRED Please fill out this field. Please enter valid data.
Street Address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email Please enter an email address.
- Children REQUIRED Please fill out this field.
- Child 1
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Male Female Please fill out this field.
  - Grade REQUIRED Please fill out this field.
  - Age REQUIRED Please fill out this field. Please enter valid data.
- Child 2
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Male Female Please fill out this field.
  - Grade REQUIRED Please fill out this field.
  - Age REQUIRED Please fill out this field. Please enter valid data.
- Child 3
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Male Female Please fill out this field.
  - Grade REQUIRED Please fill out this field.
  - Age REQUIRED Please fill out this field. Please enter valid data.
- Child 4
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Male Female Please fill out this field.
  - Grade REQUIRED Please fill out this field.
  - Age REQUIRED Please fill out this field. Please enter valid data.
- Child 5
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Male Female Please fill out this field.
  - Grade REQUIRED Please fill out this field.
  - Age REQUIRED Please fill out this field. Please enter valid data.
- Child 6
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Male Female Please fill out this field.
  - Grade REQUIRED Please fill out this field.
  - Age REQUIRED Please fill out this field. Please enter valid data.
- Child 7
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Male Female Please fill out this field.
  - Grade REQUIRED Please fill out this field.
  - Age REQUIRED Please fill out this field. Please enter valid data.
- Child 8
  - First Name REQUIRED Please fill out this field. Please enter valid data.
    
    Last Name REQUIRED Please fill out this field. Please enter valid data.
  - Date of Birth (mm/dd/yyyy) REQUIRED Please fill out this field. Please enter a date.
  - Gender REQUIRED Male Female Please fill out this field.
  - Grade REQUIRED Please fill out this field.
  - Age REQUIRED Please fill out this field. Please enter valid data.
Consent and Liability Wavier:
I grant permission for my child(ren) to participate in Vacation Bible School 2024 to be held July 8-12 from 8:30am – 12:00pm at St. Patrick Catholic Church. In consideration of my child’s participation in this event, I agree on behalf of myself, my child named herein and our heirs, successors, and assign to indemnify, hold harmless and defend the Archdiocese of Galveston-Houston, the sponsoring parish, its pastor, youth ministry leader, principal, other agents, employees or other representatives associated with the event from any and all injuries, losses, or claims arising out of my child’s participation in the event.
Youth Participant:
In signing the line below, I agree to abide by any/all policies and rules established for this event/activity (see Code of Conduct). Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that there will be consequences for my actions, including being removed from the activity and being sent home at my parents’
expense.
Video/Photography Consent:
As parent/guardian, I understand that promotional pictures and videos (individual and group) will be taken during this event. I give permission for my son’s/daughter’s picture to be used for promotional materials (newsletter, web page, calendars, power point, video, etc.) in highlighting the event.
I Agree Please select this field.

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VBS Registration

Consent and Liability Wavier:

Youth Participant:

Video/Photography Consent: