VBS Registration

St. Joseph Catholic Church Vacation Bible School 2025

Event Dates: July 27th, 28th, and 29th

Time: 5:15P.M.- 7:00 P.M.

Theme: Great Big Beautiful World

Event Address: St. Joseph Catholic Church Parish Hall

412 Main Street

Greenville, MS 38701

Contact: Olivia Lipscomb 601-906-3902 or the Church Office

Ages: VBS is for kids entering grades K-3 through 5th grade. A separate online registration form is required for each child.

***Entering K-3 kids must be potty trained to attend.

VBS Registration

Last Name

First Name

Gender

Female

Male

Date of Birth

Current School

Grade level for upcoming year?

3 year olds

Pre- Kindergarten

Kindergarten

1st

2nd

3rd

4th

5th

Parent/Guardian's Name

Parent's Guardian's Mobile Phone

Parent/Guardian's Email Address

Mailing Address

Medication Needed

No- We will do that BEFORE and AFTER each day

Yes- The Staff may distribute Prescription Medication.

Skip

Meds List, Reason, Dosage, Instructions

Do meds REQUIRE refrigeration?

Yes

Skip

Allergies? Please List

Dietary restrictions

None

Vegetarian

Vegan

Kosher

Gluten- Free

Other

Medical Insurance Carrier

Medical Insurance Policy #

Other Emergency Contacts? Please list one Emergency Contact & Mobile Number that we can contact if we are unable to reach you.

People authorized to pick up my child

Parent/ Guardian Permission: I give my permission for the child registered on this form to participate in Vacation Bible School and I release St Joseph Catholic Church from any and all liability. In case of an emergency, I give permission to transport my child to the nearest appropriate hospital for emergency medical treatment. Payment for medical emergencies is the responsibility of the Parent / Guardian.

I agree

Parent/Guardian Permission: I hereby grant permission for my child to be photographed and/or videotaped during Saint Joseph Catholic Church functions, including Religious Education and Vacation Bible School. I understand that my child may decline to be photographed and/or videotaped at any time. I understand that the resulting photographs and/or videotaped footage may be edited if necessary, and then published, including to the Saint Joseph Catholic Church website, and/or broadcast for the purpose of promoting Saint Joseph Catholic Church, which may include advertising materials, articles in the local newspaper or any other items that the priest may deem appropriate.

Yes, I grant permission.

No, I decline permission for my child to be photographed and/or videotaped during Saint Joseph Catholic Church functions. I have instructed my child to decline to be photographed and/or videotaped at all times. I have further instructed my child to notify Saint Joseph Catholic Church coordinators that he/she may not be photographed and/or videotaped under any circumstances.

Parent/ Guardian Signature

Thank you for contacting us.

We will get back to you as soon as possible.

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Office Manager

rserio@stjosephgreenville.org

CALL NOW

412 Main St, Greenville, MS, United States

662-335-5251

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