Family Information

This is a main contact number we will use during VBS.
This email will be used to send additional information to your family.
Father's Name(Required)
Mother's Name(Required)

Child Information

Child's Full Name - Child 1
MM slash DD slash YYYY
Child's Gender
Child's Grade
please let us know if your child have any allergies or other medical conditions.
Child's Full Name - Child 2
MM slash DD slash YYYY
Child's Gender
Child's Grade
please let us know if your child have any allergies or other medical conditions.
Child's Full Name - Child 3
MM slash DD slash YYYY
Child's Gender
Child's Grade
please let us know if your child have any allergies or other medical conditions.

Emergency Contact Information

Please add contact information for emergency use during the VBS class.
Emergency Contact Name(Required)
Photo Realease(Required)
St. Catherine of Siena Church/VBS has my permission to use my child’s photograph publicly in VBS materials. I understand the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.