St. Aloysius Church

“Your Faith Has Saved You”

Vacation Bible School Registration

July 6-10, 2009, 5:45 p.m.– 8:00 p.m.

Please complete one form for each child attending.

There is no fee although donations are encouraged to help offset expenses.

If your child is unable to attend all sessions, please specify the nights s/he will attend:

Mon____ Tues____ Wed____ Thurs____ Fri ____

Last Name ____________________ First Name ________________ Preferred ___________

Address ____________________________________________________ Apt. ___________

City, State Zip Code __________________________________________________________

Home Phone ______________________________

Age _____ Date of Birth _______________ Grade (Fall 2009) _____

Parent/Guardian _______________________________________________________________

Home Phone ______________ Work Phone _______________ E-mail ______________

Contact (if other than parent or guardian) ___________________________________________

Relationship _____________________

Home Phone ______________ Work Phone _______________ E-mail ______________

Emergency contact during VBS __________________________________________________

Emergency contact number during VBS ___________________________________________

Allergies/Special Medical Conditions _____________________________________________

Does your child have any special dietary restrictions? Yes/N o If yes, please specify: _____________________________________________________________________________

Special Notes _________________________________________________________________

Is this your child's first VBS at St. Al's? Yes/No

I would like to help with the VBS. Please check all that apply: Music____ Lesson____

Story-telling ____ Pre-School____ Crafts____ Snack____ Set Up____ Clean Up____

I will bring the following to the Friday night barbecue: salad_____ cold dish _____ chips_____ dessert_____ hot dog buns_____ other _____ no preference _____

OFFICE USE: __________