VBS 2022 - Registration form

- Accepting ages 5 (graduate of Kindergarten) through 6th grade.
  
  6th graders can join in or be a junior helper! See Online Volunteer Form if you would like to help.
  
  Questions: Please contact Kellie Munsch - VBS Director kelliehille1@yahoo.com / (228) 222-7979
VBS Registration Form
- The maximum number of form submissions has been reached. This form is currently not available.
  
  Name of Parents (s) REQUIRED Please fill out this field.
  
  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 REQUIRED Please fill out this field. Please enter an email address.
  
  Home Church Please enter valid data.
  
  Number of children you are registering 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.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns 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.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns 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.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns 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.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns 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.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns 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.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns 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.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns 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.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns REQUIRED Please fill out this field. Please enter valid data.
  
  Child 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns REQUIRED Please fill out this field. Please enter valid data.
  
  Child 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED
  Children must have graduated kindergarten through 6th grade.
  Please fill out this field. Please enter valid data.
  
  Age REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Information
  
  In Case of Emergency, Contact: REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Phone #: REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Relationship to Child: REQUIRED Please fill out this field. Please enter valid data.
  
  Please list anyone (other than Parent/ Caregiver) permitted to pick-up child. **They must be able to produce identification. REQUIRED Please fill out this field.
  
  Payment
  
  Amount: REQUIRED 25.0 – 1 Child 50.0 – Family Please fill out this field.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
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Our Lady of the Gulf

Catholic Church, Bay St. Louis, MS

VBS 2022 - Registration form

VBS Registration Form