2019 Vacation Bible School Child Registration

**Complete the following information for each child you wish to register.  Once the form is complete, you will be able to click on the "Pay Now" button to make your registration payment.

**MUSIC CHANGE:  St. Jude Parish can no longer provide CDs to campers due to copyright laws.  To order a digital download card of all 10 songs, please check the appropriate box on the payment portion of this form.  E-mails will be sent when download cards are available to pickup at the Parish Office.

Student Information
Student Last Name
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Oldest child if more than one attending
Parent/Guardian Name
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Address
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Daytime Phone --
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E-mail
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(for updates)
EMERGENCY CONTACT
Contact person if parent cannot be reached
Name
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Relationship
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(Grandparent, Neighbor, Friend, etc.)
Phone --
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(Daytime)
Physician's Name
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Physician's Phone --
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Medical Information
Allergies, Notes, Etc.
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Please note below any Allergies, Pertinent medical information or notes you wish to include regarding your child(ren).
Student Information
Child 1 Name
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Child 1 Age or Grade Level
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Please list age for 3 or 4 years or grade level for older children.
Child 2 Name
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Child 2 Age or Grade Level
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Please list age for children 3 or 4 years old or grade for older children.
Child 3 Name
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Child 3 Age or Grade Level
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Please list age for children 3 or 4 years old or grade for older children.
Child 4 Name
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Child 4 Age or Grade Level
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Please list age for children 3 or 4 years old or grade for older children.
Payment
Registration Fee  
Selection Extended

One Child | $35.00

Cost for one child only

One Child plus Download | $42.00

Registration for one child plus one download card

Two Children | $70.00

Two Children plus Download | $77.00

Registration for two children plus one download card

Three Children | $100.00

Three Children plus Download | $107.00

Registration for three children plus one download card

Four Children | $130.00

Four Children with One Dowload | $137.00

Registration for four children plus download card

Additional Download Card | $7.00

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Publication Permission
Parent/Guardian Permission
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The St. Jude VBS staff may be publishing information about Bible School in the bulletin, local newspapers, on the Parish website, Facebook and Diocesan publications. I give my permission for my child (parents must check if under age 18) to be photographed/videotaped within the VBS setting for publicity purposes.
Spam Capture
Spam Capture
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