St. John's Vacation Bible School (June 16-20, 2008)
Participant Registration Form: Children enrolled in Pre-K through 5th grade in 2008-2009
(6th to 12th grade students, as well as adults, can apply
 to participate as volunteers using the Volunteer Application form).

Parent /Guardian: ___________________________________________      

Family Email Address: _______________________________________

Cell Phone: _____________  Work Phone: ______________  Home Phone: _____________ 

Address: ____________________________  City: _________________  ZIP: _____________                                                      

Emergency Contact (if we can’t reach the parent/guardian): Name: ________________________  Phone ____________        

Photographs taken at VBS of my child(ren) _____may     ______may not (check one) be used in any media publication. 

Registration
Fees		 Child's Name School
Grade
(Fall 2008)		 Date of
Birth
(MM/DD/YY)		 Male/
Female		 Food
Allergies		 Child's t-shirt size:
 YXS (2-4),YS (6-8), YM (10-12),
L (14-16), Adult S,M,L,XL
1st child =
$20		            
2nd child =
+$5		            
3rd child =
+$5		            
4th child =
+$5		            
5th child =
+$5		            

   Total: $ _______ (Checks payable to St. John Catholic Church)  
   Please contact Anna Garcia at 353-8969 Ext. 39 if you need financial assistance for VBS fee. 

By signing below,  I give permission for the child(ren) listed above to attend the Power Lab Vacation Bible School at St. John the Evangelist Catholic Church.       

 Parent/Guardian Signature____________________________    Date_____________ 

 For Office Use Only:  Date Rec’d: __________  Amount paid:  $___________   Check# ________ 

Rec’d by:   ______________________________