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Vacation Bible School

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  Parent Name (s) REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Cell phone # REQUIRED Please fill out this field. Please enter valid data.
  
  Other Cell phone # Please enter valid data.
  
  Name, Cell # and relationship of others who may pick up your child. REQUIRED Please fill out this field.
  
  Children REQUIRED
  75 remaining
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  Child 1
  
  First & Last name of child Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Current age of child Please enter valid data.
  
  Grade child is entering in Fall 2025 Please enter valid data.
  
  T shirt size (Youth XS, S, M. L, XL or Adult XS, S, M, L, XL, XXL) Please enter valid data.
  
  Child 2
  
  First & Last name of child Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Current age of child Please enter valid data.
  
  Grade child is entering in Fall 2025 Please enter valid data.
  
  T shirt size (Youth XS, S, M. L, XL or Adult XS, S, M, L, XL, XXL) Please enter valid data.
  
  Child 3
  
  First & Last name of child Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Current age of child Please enter valid data.
  
  Grade child is entering in Fall 2025 Please enter valid data.
  
  T shirt size (Youth XS, S, M. L, XL or Adult XS, S, M, L, XL, XXL) Please enter valid data.
  
  Child 4
  
  First & Last name of child Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Current age of child Please enter valid data.
  
  Grade child is entering in Fall 2025 Please enter valid data.
  
  T shirt size (Youth XS, S, M. L, XL or Adult XS, S, M, L, XL, XXL) Please enter valid data.
  
  Child 5
  
  First & Last name of child Please enter valid data.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Current age of child Please enter valid data.
  
  Grade child is entering in Fall 2025 Please enter valid data.
  
  T shirt size (Youth XS, S, M. L, XL or Adult XS, S, M, L, XL, XXL) Please enter valid data.
  
  I acknowledge that I have read and understand the full document, Archdiocesan Waiver Form.
  I Agree Please select this field.
  
  I will complete the fillable PDF Vacation Bible School Waiver Form, download and email a copy to kdietz@stmaryspylesville.org as soon as possible.
  I Agree Please select this field.
  
  I acknowledge that this electronic document stands for my signature for this application and for the Archdiocesan Waiver Form.
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- Documents
  
  Archdiocesan Waiver Form