June 6th - 10th

Mon - Fri, 9 a.m. - 12 noon

For children entering 4K - 5th grade

(students must be 4 yrs old on or before Aug 15)

Parent/Guardians' Name (1):*

First Name

Last Name

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Parent Email *

Parent's Cell Phone *

Emergency Contact Name*

Emergency Contact Phone*

How many children would you like to register today?*

First Child Registration

First Child's Name

First Name

Last Name

Grade entering NEXT school year

Gender

T-Shirt Size:

To receive a VBS T-Shirt, registrations must be turned in by May 23.

Medical or other information we need to know. (Please include any food allergies)

Please describe

Is your child attending SFA Camp Timberwolf after VBS dismissal?

Please specify days and classes

Other Comments

Second Child Registration

Second Child's Name

First Name

Last Name

Grade entering NEXT school year

Gender

T-Shirt Size:

To receive a VBS T-Shirt, registrations must be turned in by May 23

Does your child have any allergies or medical conditions?

Please describe

Is your child attending SFA Camp Timberwolf after VBS dismissal?

Please specify days and classes

Other Comments

Third Child Registration

Third Child's Name

First Name

Last Name

Grade entering NEXT school year

Gender

T-Shirt Size:

To receive a VBS T-Shirt, registrations must be turned in by May 253

Does your child have any allergies or medical conditions?

Please describe

Is your child attending SFA Camp Timberwolf after VBS dismissal?

Please specify days and classes

Other Comments

Fourth Child Registration

Fourth Child's Name

First Name

Last Name

Grade entering NEXT school year

Gender

T-Shirt Size:

To receive a VBS T-Shirt, registrations must be turned in by May 23

Does your child have any allergies or medical conditions?

Please describe

Is your child attending SFA Camp Timberwolf after VBS dismissal?

Please specify days and classes

Other Comments

Fifth Child Registration

Fifth Child's Name

First Name

Last Name

Grade entering NEXT school year

Gender

T-Shirt Size:

To receive a VBS T-Shirt, registrations must be turned in by May 23

Does your child have any allergies or medical conditions?

Please describe

Is your child attending SFA Camp Timberwolf after VBS dismissal?

Please specify days

Other Comments

Payment

$25.00 per child, $50.00 max per family

Please check to agree to the terms.*

I agree

Today's Date*

In case of medical or surgical emergency, I hereby give permission to the physician selected by Saint Francis of Assisi Catholic Church or Its Representative to hospitalize and/or secure proper medical treatment for my above-named child. I understand that I am responsible for the cost of any medical treatments (including surgery) received by my child. I hereby release the directors and staff of this event from all responsibility for sickness or accidents which occur during this event. I understand that I will be contacted immediately in the case of an emergency.

Saint Francis of Assisi Catholic Church may have permission to display a photographic image of my child on its website, in its various publications (online and in print), as well as, and not limited to, Diocesan publications, promotions, and other forms of public and, or social media.

Payment Options

Payment Total - Credit/Debit $

Payment Total - Cash/Check $

Payment Total - Financial Assistance Needed $

Payment Total - Everyday Volunteer $

Payment Total - Everyday Volunteer - Office Payment $

Please come by the Church office to pay by cash or check .

Make checks payable to St. Francis Church.

If you need financial assistance, contact the office by phone.

Credit Card