VBS PARTICIPANT REGISTRATION

DOES NOT WORK WELL ON YOUR PHONE -
PLEASE USE COMPUTER

PARTICIPANT REGISTRATION-- ONLY FOR CHILDREN ATTENDING VBS
When: June 8th-12th
8:45 a.m.- 12:00 p.m.

REGISTRATION INFORMATION:

Our VBS is for children ages 4-10 year old (as of June 8th).
Enrollment is limited
Registration ends when the maximum number of participants is reached.
NO REFUNDS AFTER MAY 20th.
Participants registered after May 20th will recieve a child's size large t-shirt and are not guaranteed a CD.
Please complete and submit online registration. Registrations over the phone cannot be accepted.
No paper forms are available.
Please pay online after submitting registration.
Registrations will be processed only once payment is received.
You will receive an email confirming your registration and payment has been received.

PAYMENT INFORMATION:

Payment is now online. You may choose from Check or Credit Card.
Please be sure to submit payment online immediately after you've submitted the registration.

OTHER INFORMATION:

We are unable to group your child with other specific children.
All children will be together at the beginning and end of each day.
Children will be grouped by age not by grade.
Dismissal: Groups will be dismissed one group at a time, one child at a time. Please remember this is for the SAFETY of your child and all of the other children in our program. Patience is a virtue!

Participant fees:

$40 for 1 child (includes music CD- 1/family)

$70 for 2 children (includes music CD- 1/family)

$100 for 3 or more children (includes music CD- 1/family)

$100 maximum per family (includes music CD- 1/family)

Parent First Name: REQUIRED Please fill out this field. Please enter valid data.

Parent Last Name REQUIRED Please fill out this field. Please enter valid data.

Parent Email (This will be the MAIN form of contact): REQUIRED Please fill out this field. Please enter an email address.

Primary Phone/Cell: REQUIRED Please fill out this field. Please enter a phone number.

Secondary Phone Number REQUIRED Please fill out this field. Please enter a phone number.

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.

Emergency Contact Name: REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact Relationship: REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact Phone Number/Cell: REQUIRED Please fill out this field. Please enter a phone number.

Emergency Contact Phone Number/Secondary: Please enter a phone number.

Additional Comments:

Has/have your child(ren) ever attended VBS? Yes No Some of my children have

Is St Michael's your home parish? Yes No

If St. Michael's is your home parish, what Mass do you attend? 5:00pm Vigil - Saturday 7:30am - Sunday 9:00am - Sunday 11:00am - Sunday 12:45pm - Sunday 2:30pm Spanish - Sunday 5:30pm Life Teen - Sunday

MEDICAL RELEASE: I am the parent or legal guardian of the child/ren I am registering. I do hereby give consent to emergency medical treatment or procedures and hospital care which is deemed advisable by and is suggested, recommended, prescribed, or directed by any physician or surgeon duly licensed to practice in the Sate of Georgia. It is understood that every effort shall be made to contact the undersigned prior to rendering treatment to the patient, but that any of the above treatments will not be withheld if the undersigned cannot be reached.

Parent or Legal Guardian: I Agree Please select this field.

MEDIA RELEASE: Please indicate whether or not you grant permission for in-house publication of group (two or more persons) photos taken during VBS. REQUIRED Please fill out this field.

VBS fee: REQUIRED

Please click on the number of children you are registering for VBS: All families with participating children will receive one VBS CD as part of the VBS fee.

40 – One Child - includes one VBS CD 70 – Two Children - includes one VBS CD 100 – 3 or more Children - includes one VBS CD Please fill out this field.

Music CD REQUIRED

: If you would like additional CD's for your family it will be an additional $10 per CD. Click on the number of extra CD's you'd like to purchase:

0 – No additional VBS CD's 10 – 1 Additional VBS CD 20 – 2 Additional VBS CD's Please fill out this field.

VBS Donation

If you would like to make a donation to help with VBS costs please type in the amount.

$ Please enter a positive decimal.

Please click on the "PROCEED TO PAYMENT" button to submit this registration.
A Payment page will then display. Please complete your payment.

VBS PARTICIPANT REGISTRATION

DOES NOT WORK WELL ON YOUR PHONE - PLEASE USE COMPUTER PARTICIPANT REGISTRATION-- ONLY FOR CHILDREN ATTENDING VBS When: June 8th-12th 8:45 a.m.- 12:00 p.m.

DOES NOT WORK WELL ON YOUR PHONE -
PLEASE USE COMPUTER

PARTICIPANT REGISTRATION-- ONLY FOR CHILDREN ATTENDING VBS
When: June 8th-12th
8:45 a.m.- 12:00 p.m.