2024 VBS Online Registration

Parent/Guardian

First Name:
Required

Last Name:
Required

Address:
Required

Apt/Suite/Other:


City:
Required

State:
- Select - AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR RI SC SD TN TX UT VA VT WA WI WV WY Required

Zip:
Required

Email:
Required!

Home Phone:
Required

Cell Phone:
Required

Emergency Contact Name: (different from parents)
Required

Emergency Contact Phone Number:
Required

Parish:
Required

Would you like to be a 5 day volunteer and receive a $50.00 discount for each child off your registration fee?

Yes

No

Required