VBS Registration 2024

CAPTCHA

Family Last Name(Required)

Last

Primary Email Address(Required)

Child Information

One form per child

Child's Name(Required)

First Last

Gender(Required)

Male

Female

Date of Birth(Required)

Age(Required)

Grade Completed(Required)

T-shirt size(Required)

Did this child attend VBS last year?(Required)

Yes

Medical Information(Required)

Indicate any medical conditions your child may have. Please write “N/A” if there is no information to provide.

Parent/ Guardian Information

Father's Name(Required)

First Last

Cell Phone(Required)

Email(Required)

Mother's Name(Required)

First Last

Cell Phone(Required)

Email(Required)

Family Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

CONSENT

VBS Registration Fee(Required)

$60.00 -non refundable deposit due at time of registration

Permission to Attend:(Required)

Vacation Bible School June 10-14, 2024

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.

Permission for Image Disclosure of the Child(Required)

Please let us know if you authorize or do not authorize the use of the image of your child, by the Faith Formation department of St. Catherine of Siena Parish.

Yes, I would like to authorize it.

No, I do NOT authorize it.

Permission for image disclosure(Required)

I agree to authorize. Yes, I DO authorize the Faith Formation department of St. Catherine of Siena Parish, in Kissimmee, FL to take photos, videos or any type of recording of my child to be used in the Parish Bulletin, Parish Website, or any other parish form. I waive from any claims, and release all the staff members, volunteers of St. Catherine of Siena Catholic Church in Kissimmee, FL, and/or the Diocese of Orlando, weather former, future, or current, from any and all claims, actions, cause of actions, suits, costs, expenses, liabilities, or/and damages.

Medical Release:(Required)

I give my permission for the VBS staff to administer basic first aid to my child (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.

Name of the person who may pick up your child from VBS

Only Two Adult are required to pick up your child from VBS

Emergency Contact Information

Name(Required)

First Last

Cell Phone(Required)