Forms

VBX 2018 Registration

Complete and submit one form for each child. Cost for Week 1/2-Half Day is $20.00/ child and Week 2-Full Day is $100.00/child. You may make one payment for multiple children on the next page.
  • First Name
    Last Name
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  • Week 1 is for Children going into JK-Grade 2, it is $20/child and the program runs for 4 half-days;
    Week 2 is for Children going into Grade 3-6, the half-day is $20/child or full-day with afternoon trips for $100/child.
  • Family Information
  • First Name
    Last Name
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  • Is there a friend your child would like to be with? (please put friends' name)
  • Your child will be cared for as if (s)he were our child. It is understood that caution will be taken by the persons in charge to prevent injury, but neither those in charge nor the Church will be held responsible in case of an accident. This form also gives permission to bus your child to recreational sites if attending Week Two Full day of VBX.
  • Parent/Guardian Signature (on first day of VBX):_______________________
  • Payment options are on the next page.
    Notes: Registrations without payment are not complete. Please complete one registration form for each child. You may make one payment for multiple children.