Child Registration for VBS 2026
July 13-16 from 9:00am to Noon | Please complete all fields to register your child for our Summer 2026 VBS program.
Parent Name
*
Phone
*
Email
*
This address will receive a confirmation email
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Child Name and Birthday
*
2026-2027 Grade Level
*
Please select one option.
Pre-School (ages 3-4)
K
1
2
3
4
5
Select Option
Pre-School (ages 3-4)
K
1
2
3
4
5
Shirt Size (unisex)
*
Please select one option.
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Select Option
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
I give permission for my child's photo/video to be used in St. Cuthbert's promotional materials, including website, social media and printed materials
*
Please select all that apply.
Yes, I do give my permission.
No, I do not give my permission.
Does your child have any special needs/allergies we should be aware of?
*
Child #2 Name and Birthday
2026-2027 Grade Level
Please select one option.
Pre-School (ages 3-4)
K
1
2
3
4
5
Select Option
Pre-School (ages 3-4)
K
1
2
3
4
5
Shirt Size (unisex)
Please select one option.
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Select Option
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
I give permission for my child's photo/video to be used in St. Cuthbert's promotional materials, including website, social media and printed materials.
*
Please select all that apply.
Yes, I give my permission
No, I do not give my permission
Does your child have any special needs/allergies we should be aware of?
Child #3 Name and Birthday
2026-2027 Grade Level
Please select one option.
Pre-School (ages 3-4)
K
1
2
3
4
5
Select Option
Pre-School (ages 3-4)
K
1
2
3
4
5
Shirt Size (unisex)
Please select one option.
Youth Small
Youth Medium
Youth Large
Adult Large
Adult Medium
Adult Large
Adult XL
Adult XXL
Select Option
Youth Small
Youth Medium
Youth Large
Adult Large
Adult Medium
Adult Large
Adult XL
Adult XXL
I give permission for my child's photo/video to be used in St. Cuthbert's promotional materials, including website, social media and printed materials.
*
Please select all that apply.
Yes, I do give my permission
No, I do not give permission.
Does your child have any special needs/allergies we should be aware of?
Please Note: A parent must stay with any child that requires one-on-one care.
Emergency Contact Name(s), Phone Number(s) and Relationship.
*
If paying by cash or check, please choose the Cash/Check $0 option in the drop down menu.
Payment $20 per child
One Child ($20)
Two Children ($40)
Three Children ($60)
Pay by Check/Cash ($0)
One Child ($20)
Two Children ($40)
Three Children ($60)
Pay by Check/Cash ($0)
Amount
If you have more than three children, please fill out a separate form.
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
Description
July 13-16 from 9:00am to Noon
Please complete all fields to register your child for our Summer 2026 VBS program.
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