Clone of VBS 2025: Camper Registration Form

Family Information

Parent Contact Details
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Parent E-mail
Parent Phone Number
Phone Number

Area CodePhone Number
Registration Details

For Campers in Grades K - 5 in September 2026
How many campers will you be registering?
Authorized to pick up child(ren):
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
We are parishioners of:*
Camper 1 Information
Name

First NameLast Name
Grade as of Sep 1, 2026
Birth Date

MonthDayYear
Age
Gender
Allergies/Concerns/Comments
If you do not have any additional campers to register, please scroll to the bottom of this page to complete your payment and submit this form.
Camper 2 Information
Name

First NameLast Name
Grade as of Sep 1, 2026
Birth Date

MonthDayYear
Age
Gender
Allergies/Concerns/Comments
If you do not have any additional campers to register, please scroll to the bottom of this page to complete your payment and submit this form.
Camper 3 Information
Name

First NameLast Name
Grade as of Sep 1, 2026
Birth Date

MonthDayYear
Age
Gender
Allergies/Concerns/Comments
If you do not have any additional campers to register, please scroll to the bottom of this page to complete your payment and submit this form.
Camper 4 Information
Name

First NameLast Name
Grade as of Sep 1, 2026
Birth Date

MonthDayYear
Age
Gender
Allergies/Concerns/Comments:
If you do not have any additional campers to register, please scroll to the bottom of this page to complete your payment and submit this form.
Camper 5 Information
Name

First NameLast Name
Grade as of Sep 1, 2026
Birth Date

MonthDayYear
Age
Gender
Allergies/Concerns/Comments:
If you do not have any additional campers to register, please scroll to the bottom of this page to complete your payment and submit this form.
Payment and Submission
Calculation

Total Amount Due:*

USD

Payment Information

You are not registered until you hit the submit button!
Should be Empty:

Family Information

Registration Details

Camper 1 Information

Camper 2 Information

Camper 3 Information

Camper 4 Information

Camper 5 Information

Payment and Submission

Payment Information