Donate . Contact Us

- Accepting ages 5 (graduate of Kindergarten) through 6th grade.
  
  Scholarships available upon request.
  Space is limited to 80 children.
  Cost $25.00 per child / $50.00 for family
  Questions: Please contact Cecilia Escobedo - VBS Director [email protected]
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
  34 remaining
  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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed 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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed 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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed 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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed 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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed 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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed 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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed 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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed 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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed 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 of child @ time of VBS (June 17) REQUIRED Please fill out this field.
  
  Last Grade Completed REQUIRED Please fill out this field.
  
  Allergies or Other Medical Needs or Concerns REQUIRED Please fill out this field. Please enter valid data.
  
  My child is allowed to be photographed for pictures that may be used on social media REQUIRED yes no Please fill out this field.
  
  We want your child to have a great experience at VBS! Is there any additional information that might help us ensure your child has a great week at VBS? (ex. special needs or accommodations, strategies for behavioral challenges, etc.)
  
  Emergency Contact #1
  
  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.
  
  Emergency Contact #2
  
  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
  
  My child's spot is not secure unless paid in full and registration completed. REQUIRED I understand. Please fill out this field.
  
  Amount: REQUIRED 25.0 – 1 Child 50.0 – Family Please fill out this field.
  
  Total:
  
  Submit
  
  Proceed to Payment
  
  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Our Lady of the Gulf

Catholic Church, Bay St. Louis, MS

VBS Registration Form