Wufoo

St. Aloysius Church

"Come to the Water"

Vacation Bible School Registration

July 9-13, 2012, 5:45 p.m.– 8:00 p.m.
Please complete one form for each child attending.

Please complete ONE form for each child attending.
There is no fee although donations are encouraged.
If your child is unable to attend all sessions, please specify the nights s/he will attend:
Monday Tuesday Wednesday Thursday Friday
Name * First Last
Preferred Name
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Home Phone Number * ### - ### - ####
Email
Date of Birth * MM / DD / YYYY
age
Grade ( Fall 2011) *
Parent and Contact Information
Parent/Guardian Name * First Last
Work Phone Number * ### - ### - ####
Home Phone Number * ### - ### - ####
Email *
Contact (if other than parent or guardian) First Last
Relationship
Home Phone Number ### - ### - ####
Work Phone Number ### - ### - ####
Email
Emergency contact during VBS * First Last
Emergency contact number during VBS * ### - ### - ####
Allergies/Special Medical Conditions *
Does your child have any special dietary restrictions? Yes/No If yes, please specify:
Special Notes
Is this your child's first VBS at St. Al's?
Yes No
I would like to help with the VBS. Please check all that apply:
Music Lesson Storytelling Pre-School Craft Snack Set up Clean Up
I will bring the following to the Friday night barbecue:
Salad Cold Dish Chips Dessert Hot Dog Buns Other No Preference
Do Not Fill This Out