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VBS Registration Form For participants & Youth Volunteers attending True North - Trusting Jesus in a Wild World VBS!

- Faith Formation

Let's get registered!
Adult Volunteers - Please take a moment to click on the link below and navigate to our VBS Adult Volunteer Form for registration:
https://stannesomerset.org/vbs-volunteers
Any youth volunteers (6th - 12th Grade) or children registering to participate in VBS should continue with the registration form below.
Expected Costs:
- $25/Student or $100 max/family
Registration closes on July 14 - no late registrations will be accepted.
This form is not accepting responses at this time.
- Thank you for your interest in True North - Trusting Jesus in a Wild World VBS! We can't wait to explore the northern tundra and help children learn that:
  when we wonder, we can trust Jesus!
  when we feel alone, we can trust Jesus!
  When we feel powerless, we can trust Jesus!
  when we need hope, we can trust Jesus!
  when we need help, we can trust Jesus!
- Adult Completing this Form:
- First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
- Email REQUIRED Please fill out this field. Please enter an email address.
- What parish are you associated with: REQUIRED Please fill out this field.
- If other, please name: Please enter valid data.
- NEW THIS YEAR! We have consolidated permission forms. This form may be used to register your child(ren) participating in VBS AND any child(ren) you have volunteering to be a youth leader at VBS (6th grade and older, only). Please note that participants are the only ones who pay a registration fee. Volunteers are free. Please select how many children you have in total participating and volunteering. You will then fill out each child's information and select if a participant or a volunteer.
- Number of Participants and Volunteers to Register REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Maximum 18 characters Please fill out this field. Please enter an integer (number) from 0 to 18.
  
  Current Grade (2024-2025) REQUIRED Please fill out this field.
  
  Confirm Child Registration REQUIRED Child Participant Registration (age 3 - entering grade 5 in 2025-2026) Youth Volunteer Registration (entering Grade 6 through 12 in 2025-2026) Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  List allergies/medical concerns/special needs and please be specific about necessary treatment we may need to utilize: Please enter valid data.
  
  Crew requests (note that not all requests can/will be honored but we do try our best): Please enter valid data.
  
  Youth volunteers, please state your preference for how you would like to volunteer:
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Maximum 18 characters Please fill out this field. Please enter an integer (number) from 0 to 18.
  
  Current Grade (2024-2025) REQUIRED Please fill out this field.
  
  Confirm Child Registration REQUIRED Child Participant Registration (age 3 - entering grade 5 in 2025-2026) Youth Volunteer Registration (entering Grade 6 through 12 in 2025-2026) Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  List allergies/medical concerns/special needs and please be specific about necessary treatment we may need to utilize: Please enter valid data.
  
  Crew requests (note that not all requests can/will be honored but we do try our best): Please enter valid data.
  
  Youth volunteers, please state your preference for how you would like to volunteer:
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Maximum 18 characters Please fill out this field. Please enter an integer (number) from 0 to 18.
  
  Current Grade (2024-2025) REQUIRED Please fill out this field.
  
  Confirm Child Registration REQUIRED Child Participant Registration (age 3 - entering grade 5 in 2025-2026) Youth Volunteer Registration (entering Grade 6 through 12 in 2025-2026) Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  List allergies/medical concerns/special needs and please be specific about necessary treatment we may need to utilize: Please enter valid data.
  
  Crew requests (note that not all requests can/will be honored but we do try our best): Please enter valid data.
  
  Youth volunteers, please state your preference for how you would like to volunteer:
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Maximum 18 characters Please fill out this field. Please enter an integer (number) from 0 to 18.
  
  Current Grade (2024-2025) REQUIRED Please fill out this field.
  
  Confirm Child Registration REQUIRED Child Participant Registration (age 3 - entering grade 5 in 2025-2026) Youth Volunteer Registration (entering Grade 6 through 12 in 2025-2026) Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  List allergies/medical concerns/special needs and please be specific about necessary treatment we may need to utilize: Please enter valid data.
  
  Crew requests (note that not all requests can/will be honored but we do try our best): Please enter valid data.
  
  Youth volunteers, please state your preference for how you would like to volunteer:
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Maximum 18 characters Please fill out this field. Please enter an integer (number) from 0 to 18.
  
  Current Grade (2024-2025) REQUIRED Please fill out this field.
  
  Confirm Child Registration REQUIRED Child Participant Registration (age 3 - entering grade 5 in 2025-2026) Youth Volunteer Registration (entering Grade 6 through 12 in 2025-2026) Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  List allergies/medical concerns/special needs and please be specific about necessary treatment we may need to utilize: Please enter valid data.
  
  Crew requests (note that not all requests can/will be honored but we do try our best): Please enter valid data.
  
  Youth volunteers, please state your preference for how you would like to volunteer:
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Age REQUIRED Maximum 18 characters Please fill out this field. Please enter an integer (number) from 0 to 18.
  
  Current Grade (2024-2025) REQUIRED Please fill out this field.
  
  Confirm Child Registration REQUIRED Child Participant Registration (age 3 - entering grade 5 in 2025-2026) Youth Volunteer Registration (entering Grade 6 through 12 in 2025-2026) Please fill out this field.
  
  Gender REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Please fill out this field.
  
  List allergies/medical concerns/special needs and please be specific about necessary treatment we may need to utilize: Please enter valid data.
  
  Crew requests (note that not all requests can/will be honored but we do try our best): Please enter valid data.
  
  Youth volunteers, please state your preference for how you would like to volunteer:
- Number of Parent/Legal Guardian REQUIRED Please fill out this field.
  
  Parent/Legal Guardian 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Primary Day Telephone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Secondary Telephone Number Maximum 20 characters Please enter a phone number.
  
  Parent/Legal Guardian 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Primary Day Telephone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Secondary Telephone Number Maximum 20 characters Please enter a phone number.
  
  Parent/Legal Guardian 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Primary Day Telephone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Secondary Telephone Number Maximum 20 characters Please enter a phone number.
  
  Parent/Legal Guardian 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Primary Day Telephone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Secondary Telephone Number Maximum 20 characters Please enter a phone number.
  
  Parent/Legal Guardian 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Primary Day Telephone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Secondary Telephone Number Maximum 20 characters Please enter a phone number.
  
  Parent/Legal Guardian 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  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.
  
  Zip REQUIRED Please fill out this field. Please enter a zip code.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Primary Day Telephone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Secondary Telephone Number Maximum 20 characters Please enter a phone number.
- Please respond to this next section for all children that are being registered. Thank you!
  Emergency Contact 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.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Relationship to Student(s) REQUIRED Please fill out this field. Please enter valid data.
- Emergency Hospital Name REQUIRED Please fill out this field. Please enter valid data.
- Emergency Hospital Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Family Physician REQUIRED Please fill out this field. Please enter valid data.
- Medical Clinic Name REQUIRED Please fill out this field. Please enter valid data.
- Medical Clinic Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Dentist Name REQUIRED Please fill out this field. Please enter valid data.
- Dentist Phone Number REQUIRED Please fill out this field. Please enter valid data.
- Eye Doctor REQUIRED Please fill out this field. Please enter valid data.
- Eye Doctor Phone Number REQUIRED Please fill out this field. Please enter valid data.
- I hereby authorize the healthcare provider or designated person to contact the above listed physician in case of an emergency and parent/legal guardian cannot be reached. REQUIRED Please fill out this field.
- I hereby give permission to chaperones of St. Anne Catholic Church and Immaculate Conception/St Patrick Catholic Church to distribute non-prescription/over-the-counter medications and treatments to my child/ward such as but not limited to: applying bandages, first-aid ointments or sprays, ice/heat compresses, dispensing of non-aspirin pain relievers, cough drops, syrups, and antacids and the like.
- I agree: REQUIRED Please fill out this field.
- I give permission for my child(ren) to participate in True North - Trusting Jesus in a Wild World Vacation Bible School being hosted by Immaculate Conception/St Patrick Church and St. Anne Catholic Church. By selecting "yes" in the box below, I am saying "yes" to this statement and, I understand the risks and hazards associated with the event, including injury, illness, and the rare possibility of death. I understand that I may discuss any concerns or questions I have about this event with a representative of St. Anne Catholic Church or Immaculate Conception/St Patrick Catholic Church or the Diocese of Superior prior to giving permission for my child(ren) to participate. In consideration for my child(ren)'s participation, I agree to reimburse and indemnify St. Anne Catholic Church and/or Immaculate Conception/St Patrick Catholic Church and the Diocese of Superior for all reasonable legal and court fees incurred by the parishes/diocese in defending a lawsuit that I or my child/ren may bring against the parishes/diocese which relates to VBS if the parishes/diocese is found not legally liable by the courts and prevails in the lawsuit. If the parish/diocese is found legally liable for any injuries sustained by my child(ren), this paragraph will not apply. I further agree to reimburse the diocese or any other agency for property damage or any bodily harm to other participants caused by my child/ren.
- I agree: REQUIRED Please fill out this field.
- Image & Likeness Release. I give Immaculate Conception/St. Patrick and St. Anne parishes permission to use any image of my child in both print and electronic publicity. The videotape, photograph, slide, audiotape, or any other visual or audio reproduction in which my child may appear may include promotional activities such as, but not limited to, websites, social media sites, newsprint, flyers, or brochures. Immaculate Conception/St Patrick & St. Anne parishes reserve the rights to determine which image and likeness is used and how long it will remain on the site or is used in media materials.
- I agree to the Image & Likeness Release: REQUIRED Please fill out this field.
- Would you like to receive future emails about the happenings in our parish life for your child & family? REQUIRED Please fill out this field.
- **STOP - THIS IS IMPORTANT TO READ - PLEASE READ THIS ENTIRE SECTION BEFORE PROCEEDING!**: If you are paying by check, please select the pay later feature of this form and drop off or mail your check to the St. Anne Parish Office,
  Attention: Rachel McGurran
  Address: 141 Church Hill Road, Somerset, WI, 54025
  If you are paying by credit card, please select the pay now feature and complete the next section.
- Registered Number of Children for Payment (only pay for the number of participants in VBS; youth volunteers are free): REQUIRED Please fill out this field.
Total:

Submit

Pay Now

Pay Later

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