VBS REGISTRATION FORM
|
Child’s
First and Last Name |
Grade fall 2008 |
T-Shirt
Size Circle One |
List Any
Allergies / Medical
Information |
|
|
|
XS S M L |
|
|
|
|
XS S M L |
|
|
|
|
XS S M L |
|
|
|
|
XS S M L |
|
Mother: ________________________________ Father: ___________________________________
Mother’s Cell Phone: _____________________ Father’s Cell Phone:
________________________
Home Phone: ___________________________ Email Address: _____________________________
Address: ______________________________ City: ____________________ Zip: _______________
Emergency Contact: Name and Relationship: ______________________________ Phone: _____________
These adults have
permission to pick up my children:
Name: _____________________________________ Cell Phone:
___________________________
Name: _____________________________________ Cell Phone:
___________________________
I give permission for my children’s image, photo, or
video coverage (without names) to be displayed
including on the parish website, for purposes
that are related to parish activities. I
give permission
for my children to use hand sanitizer.
Parent/Guardian Signature: ____________________________________ Date: _____________________
Registration
Fee (payment required at time of registration)
Before May 7
- $50/child $100/family max
After May 7
- $60/child $120/family max
Mail Registration Form and check
(payable to Our Lady of Grace) to:
Our Lady of
Grace, Attn: VBS