Vacation Bible School Registration Form

When you submit this form, all of the information will be sent by e-mail to St. James Catholic Church.

* Required fields
  Student-* Type     
Title *First Name *Last Name Suffix
Birth Date:   Gender:  Female  Male
To fill out the form ...
Registration Fee    Vacation Bible School is free to all
1st Class Choice
Help Needed for VBS
Additional Information (Special Circumstances, medication, allergies...)

* Required fields
Head of Household
Title * First Name * Last Name Suffix
Birth Date:   * Gender:  Female  Male
Spouse
Title First Name Last Name Suffix
Birth Date:   Gender:  Female  Male
Address
* Line 1
   Line 2
* City
* State
* ZIP
   E-Mail
Send E-Mail Instead of Mail When Possible
Phone
* Primary ( ) - Unlisted
   Other ( ) - Unlisted
Emergency Contact Information
Title First Name Last Name Suffix
Relationship  
Address for Emergency Contact
Line 1  
City    
State    
Zip       -
Email    use Email
Phone for Emergency Contact
Primary Phone    
() - Unlisted
Other Phone       
() - Unlisted

When you submit this form, all of the information will be sent by e-mail to St. James Catholic Church.