Vacation Bible School Registration

Parent Name*

First Last

Parent Email Primary*

Parent Email Secondary*

Parent Primary Phone*

Emergency Contact #1*

First Last

Emergency Contact #1 Phone*

Emergency Contact #2*

First Last

Emergency Contact #2 Phone*

Do you plan to be an Adult Helper?*

Yes
No
I have questions, please contact me

If you are undecided, after submitting this form, do not pay online. Our VBS staff liaison, Julia Acosta, will contact you to discuss these adult volunteer positions.

Please indicate which volunteer position you would like?*

Are you current with your Archdiocese of Atlanta Safe Environment certification?*

Yes
No
I don't know.

If No or Don't Know - Please contact Siobhan Finnegan at sfinnegan@judeatl.com immediately to verify or begin the process.

For 5 Day Volunteers - Will you need babysitting for younger children?*

Yes
No

Please list names and ages here*

Consent*

I agree to the media policy

Saint Jude uses images, interviews, and videos of our children for a variety of internal and external communications. Our forms of internal and external communications include but are not limited to: print, such as newspapers, bulletins, and newsletters; photographs and digital images; film and videos; web posts, web pages, and image carousels.
I hereby grant permission for Saint Jude the Apostle to use images and interviews of my child for internal or external communications.

Consent*

I agree to the medical policy.

I understand that reasonable precautions will be taken to safeguard the health and well being of the participants in this Vacation Bible School, and that I will be notified as soon as possible in the event of any emergency. In the case of sickness or an accident, I authorize and give consent to the VBS team, or other associated volunteers of the VBS program, to obtain medical care from a licensed physician, hospital, or medical clinic for my s on/daughter in the event that myself or other legal guardian(s) cannot be reached. I hereby do release and forever discharge the Archdiocese of Atlanta and Saint Jude the Apostle Catholic Church from all manners of actions or claims, which I or my child(ren) shall or may have for any reason, arising from my child's attendance of the VBS program.

How many children are you registering for VBS?*

Name Child #1*

First Last

Child #1 Grade Fall 2019*

Child #1 Date of Birth*

Child #1 Gender*

Child #1 T-Shirt Size*

Does Child #1 have any allergies of note for VBS?*

Yes
No

Please explain*

Does Child #1 have any special needs that would affect their time at VBS?*

Yes
No

Please explain*

Child #2

Name Child #2*

First Last

Child #2 Grade Fall 2019*

Child #2 Date of Birth*

Child #2 Gender*

Child #2 T-Shirt Size*

Does Child #2 have any allergies of note for VBS?*

Yes
No

Please explain*

Does Child #2 have any special needs that would affect their time at VBS?*

Yes
No

Please explain*

Child #3

Name Child #3*

First Last

Child #3 Grade Fall 2019*

Child #3 Date of Birth*

Child #3 Gender*

Child #3 T-Shirt Size*

Does Child #3 have any allergies of note for VBS?*

Yes
No

Please explain*

Does Child #3 have any special needs that would affect their time at VBS?*

Yes
No

Please explain*

Vacation Bible School

Child #2

Child #3

Location

Info