VBS CAMPER Registration

2022 VBS Camper Registration Form

Assumption Parish children entering Pre-K4 through 3rd Grade this September are eligible to join the program. Registration fee is $65 per child.

Number of VBS Campers registering in your family REQUIRED Please fill out this field.
Camper 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.
- Grade entering as of September 2022 Pre-K 4 Kindergarten Grade 1 Grade 2 Grade 3
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- School your child will be attending in the Fall REQUIRED Please fill out this field. Please enter valid data.
- Does your child have any allergies or special needs of any kind? Please enter valid data.
- Does your child have a preference of anyone they would like to be placed with? Please enter valid data.
Camper 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.
- Grade entering as of September 2022 Pre-K 4 Kindergarten Grade 1 Grade 2 Grade 3
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- School your child will be attending in the Fall REQUIRED Please fill out this field. Please enter valid data.
- Does your child have any allergies or special needs of any kind? Please enter valid data.
- Does your child have a preference of anyone they would like to be placed with? Please enter valid data.
Camper 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.
- Grade entering as of September 2022 Pre-K 4 Kindergarten Grade 1 Grade 2 Grade 3
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- School your child will be attending in the Fall REQUIRED Please fill out this field. Please enter valid data.
- Does your child have any allergies or special needs of any kind? Please enter valid data.
- Does your child have a preference of anyone they would like to be placed with? Please enter valid data.
Camper 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.
- Grade entering as of September 2022 Pre-K 4 Kindergarten Grade 1 Grade 2 Grade 3
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- School your child will be attending in the Fall REQUIRED Please fill out this field. Please enter valid data.
- Does your child have any allergies or special needs of any kind? Please enter valid data.
- Does your child have a preference of anyone they would like to be placed with? Please enter valid data.

Parent Information

Parent First Name REQUIRED Please fill out this field. Please enter valid data.
Parent Last Name REQUIRED Please fill out this field. Please enter valid data.
Address 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.
Cell Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Home Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Alternate Phone Number Please enter valid data.
Email REQUIRED Please fill out this field. Please enter an email address.
Emergency Contact Name (other than parent) REQUIRED Please fill out this field. Please enter valid data.
Emergency Contact Phone Number (other than parent) REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.

Are you interesting in volunteering for VBS Yes No Need more information

If you become a VBS adult volunteer, babysitting is provided for siblings not old enough for the program. Camper registration fees are waived for any full-time volunteer (Monday through Friday of VBS week). If you have a child in grades 4 or 5 who wishes to be a Jr. volunteer, they are welcome to volunteer on the days you will also be volunteering. Please fill out an adult volunteer registration form if interested.

Publication Waiver

Dear Parents/Guardians,

As part of your son’s/daughter’s Vacation Bible School experience, he/she may have the opportunity to publish his/her work (photographs of compositions, projects, and/or drawings). In addition, your son or daughter may be photographed alone or with other camp participants. Images may be published in various media outlets such as the parish bulletin, The Beacon (our Diocesan newspaper) as well as secular publications. Newspapers may also have online versions of the stories.

Photographs and published work of campers will include a camper’s name and indicate participation in Vacation Bible School at Assumption Parish.

Photographs and published work of campers will never include a camper’s phone number, street address, email address, or information about family members.

This waiver is designed to obtain your permission to include your son/daughter in these publications from time to time.

Respectfully yours,

Chrissy Fugger and Catherine Hudak

VBS Coordinators

Publication Waiver VBS 2022 REQUIRED I Accept I Do Not Accept Please fill out this field.