Camping with Christ

VBS
Summer 2022St. William Catholic Church
(One Form Per child) DEADLINE TO REGISTER IS June 20th
Return with fee to PowerNancy@comcast.net
or 2300 Frederica Rd, SSI, GA 31522
For rising K thru fifth grades – Fee per child is $15
June 27-30, 2022 – 9:00 AM-Noon

Student Name:

Age:

Grade Entering the Fall:

Cell Phone No.:

Family E-mail:

Parent's (Family) Name:

Home Address:

City:

State:

Zip:

Emergency Contact:

Phone No:

School Attends:

Alternate Pickup Name and No.:

Home Church:

Special Concerns: - Allergies, Educational, Dietary, Health, Social, etc.:

Medical Release: I give my permission for the VBS staff to administer basic first aid to my child (named above) in the event of an injury. I understand that the VBS staff will contact emergency services in the event of a significant injury and all expenses for such emergency which will be paid by me. Photo Release: I hereby grant St. William permission to copyright and use photographs/videos taken at VBS of the minor. I waive any right that O may have to inspect or approve the finished product, which may be used in conjunction therewith, or the use to which it may be applied. Permission to Attend: I give permission for my child to attend the VBS listed above.

Signature:

Date:

Fee for child is $15 per Child:

Office use only: Registered /Paid - Amount:

Cash:

CK #:

Date:

VBS Summer 2022St. William Catholic Church (One Form Per child) DEADLINE TO REGISTER IS June 20th Return with fee to PowerNancy@comcast.net or 2300 Frederica Rd, SSI, GA 31522 For rising K thru fifth grades – Fee per child is $15 June 27-30, 2022 – 9:00 AM-Noon

VBS
Summer 2022St. William Catholic Church
(One Form Per child) DEADLINE TO REGISTER IS June 20th
Return with fee to PowerNancy@comcast.net
or 2300 Frederica Rd, SSI, GA 31522
For rising K thru fifth grades – Fee per child is $15
June 27-30, 2022 – 9:00 AM-Noon