V.B.S. Online Registration

Please complete a separate online registration form for each child.

Registration must be received by June 1, 2023 to guarantee desired t-shirt size.

Child's Information:

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

Grade for 2023-2024 School Year REQUIRED 4 yr old Preschool Kindergarten 1st Grade 2nd Grade 3rd Grade 4th Grade 5th Grade Please fill out this field.

T-shirt size REQUIRED Youth X-small Youth Small Youth Medium Youth Large Youth X-large Adult Small Adult Medium Adult Large Adult X-large Please fill out this field.

Age REQUIRED Please fill out this field. Please enter valid data.

Allergies or Special Needs: Please list all. If none, then please type N/A REQUIRED Please fill out this field.

Parent's Information

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.
Street Address REQUIRED Please fill out this field. Please enter valid data.
City REQUIRED Please fill out this field. Please enter valid data.
State REQUIRED Please fill out this field. Please enter valid data.
Zip Code REQUIRED Please fill out this field. Please enter valid data.
Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
Email Address REQUIRED Please fill out this field. Please enter valid data.

Person responsible for pick up (if other than parent) & phone number: Please enter valid data.

Emergency Contact Name & Number: REQUIRED Please fill out this field. Please enter valid data.

Children will be placed in groups with other children of similar ages. If there is a particular friend or sibling that your child would like to be with, please list them below.

Friend or sibling to stay with REQUIRED Please fill out this field. Please enter valid data.

**Photo/Video Release
I hereby give permission to St. Columbkill Church to use photo and/or video of my child on our website, facebook page and in our closing ceremony. Please type below for your Electronic Signature.

Electronic Signature of Parent/Guardian-Print REQUIRED Please fill out this field. Please enter valid data.

Student Fee is $20 for the one child for the week., $15 for each additional child registered in the same family. You can click on the link below and it will take you to the payment page.

St. Columbkill

Boyertown, PA ~ (610) 367-2371

Vacation Bible School - Student Online Registration

2023 Vacation Bible School Registration Fee-Pay Here Online