St. Ignatius, VBS Registration Form 2019

June 23-29;

Contact Information
Child's Name
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Childs Age
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Childs' Gender
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Date of Birth
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Name Parent(s)
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Last School grade completed
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Address
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Country
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E-mail
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Phone -- ext
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Parent/caregiver's cellphone -- ext
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Home Parish
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Crew number or Name (For Parish use Only)
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Allergies or Other Medical conditions- Contact
Phone -- ext
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Relationship to Child
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In case of Emergency Contact
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VBS FEES - AGES 4YRS to 6TH GRADE
1 Child
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AMT PAID $
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Childrens T Shirt Sizes
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Media/Photo Waiver
I Authorize
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By checking the following box, I hereby authorize and give my full consent to St. Ignatius and the Diocese of Nashville to copyright and/or publish any and all photographs, video or audio in which I/my child will appear while attending St. Ignatius functions during VBS. I further agree that St. Ignatius and Diocese of Nashville may transfer these photographs, video, or audio for use on the St. Ignatius and the Diocese of Nashville websites and all promotional material.
Spam Capture
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