Vacation Bible School Registration

- Faith Formation

Vacation Bible School 2022 Registration
The maximum number of form submissions has been reached. This form is currently not available.
- Family Information
- Family Last Name REQUIRED Please fill out this field. Please enter valid data.
- Family 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.
- Family Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Main Family Email REQUIRED Please fill out this field. Please enter valid data.
- Preferred Communication Method REQUIRED Please fill out this field.
- Photo Release - Do you give St. Theresa Catholic Church permission to photograph or video your child to use and publish online or in print only on official parish website or print media REQUIRED Please fill out this field.
- Emergency Contact Information
- Emergency Contact REQUIRED Please fill out this field. Please enter valid data.
- Emergency Contact Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Child's/Children Information
- Number of Children REQUIRED Please fill out this field.
  
  Children Information 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
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Grade for 2022-2023 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Allergies, Medical Conditions or Special needs REQUIRED Please fill out this field. Please enter valid data.
  
  Children Information 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
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Grade for 2022-2023 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Allergies, Medical Conditions or Special needs REQUIRED Please fill out this field. Please enter valid data.
  
  Children Information 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
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Grade for 2022-2023 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Allergies, Medical Conditions or Special needs REQUIRED Please fill out this field. Please enter valid data.
  
  Children Information 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
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Grade for 2022-2023 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Allergies, Medical Conditions or Special needs REQUIRED Please fill out this field. Please enter valid data.
  
  Children Information 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
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Grade for 2022-2023 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  Allergies, Medical Conditions or Special needs REQUIRED Please fill out this field. Please enter valid data.
Submit

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Please pay after submitting this registration form (see confirmation email or click on the "Pay Here" button below).
VBS Payment

Financial questions or concerns?
Please contact Tommy Cordova at: t.cordova@sttheresa.cc or by calling 346-335-1816