VACATION BIBLE SCHOOL REGISTRATION
MAKER FUN FACTORY - JUNE 12 - 16, 2017


Registration Deadline is June 9, 2017.
 *Child's Name  
 *Date of Birth  
 *Age  
 *Grade child COMPLETED in 2016/2017  
 *School  
 *Church Parish  
 *Parent Name  
 *Address  
 *City  
 *Zip  
 *Phone Number  
 *Emergency Phone Number  
* Allergies  
Allergies considered a Medical Emergency?
 
  Yes     No
Medical Conditions (ADD, ADHD, etc.)  
* I would like to help with VBS
 
  Yes
  No
* I would like to donate rerfreshments
 
  Yes
  No
* I grant permission for St. Alphonsus Catholic Church to use pictures of this child in media releases and online communications, including the parish webiste or parish social-networking sites, for infomational or promotiaonal purposes
 
  Yes
  No
 
  * Indicates required fields
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14040 Greenwell Springs RoadGreenwell Springs, LA 70739P 225.261.4650F 225.261.5650