VBC

Child's Name *

First

Last

Please fill out a form for each child

Sex *

Male
Female

Age of child *

Grade completed in June *

T-shirt size *

Allergies or medical conditons *

If none, please indicate none.

Health Insurance (Name, Group number) Physician name and phone number

Family Information (parents/guardians names and address) *

Family home phone number

Work phone number

Cell phone number *

Email *

Email

Confirm Email

EMERGENCY CONTACT *

Name and phone number

VBC payments are $50 for 1st child ($40 for second child & $15 for additonal children from same household) and will pay as below: *

Cash (Submit to Lisa or Rectory Staff)
Check made payable to St Martin of Tours VBC (Submitt to Lisa or Rectory Staff)
Paying Online (To pay on-line, use the Tithe/Donate/Pay button below, or on parish home webpage. Click on VBC and put amount and your family name.)
Payment for multiple children from same household made with other child/form

Registration is not complete until payment has been received.

LIABILITY RELEASE: I understand that reasonable precautions will be taken to safeguard the health and well being of the participants in this VBC and that I will be notified as soon as possible in the event of an emergency. In the case of sickness or an accident, I authorize and consent the VBC Team, or other associated volunteers of the VBC program to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that myself or other legal guardian(s) cannot be reached. I hereby do release and forever discharge this Diocese, and Parish from all manners of actions, claims which I or the child named above shall or may have for any reason, arising during my child’s attendance of the VBC. Unless other written instruction is submitted, I also consent to allowing my child’s image to be recorded, either by photograph or video, and used during the VBC week or for future advertisement of Parish VBC programs. Any other use will require further consent. *

Entering your name here indicates you agree with the verbiage.

* * * * * Shine Jesus’ Light * * * * *

VACATION BIBLE CAMP at St. Martin of Tours 2023
Summer program for children 4-11 (just completed 5th grade)

July 10-14, 2023 – 9am-noon

VBC

* * * * * Shine Jesus’ Light * * * * *

VACATION BIBLE CAMP at St. Martin of Tours 2023 Summer program for children 4-11 (just completed 5th grade)

July 10-14, 2023 – 9am-noon

VACATION BIBLE CAMP at St. Martin of Tours 2023
Summer program for children 4-11 (just completed 5th grade)