Please indicate below: REQUIRED Holy Family parishioner Holy Family Day School family 2023 Holy Family VBS Participant Other parish: Please fill out this field.

If "other" is checked, what is your home parish? Please enter valid data.

If not affiliated with Holy Family, how did you hear about us? A friend from Holy Family Poster Email or Flocknote Social Media Bulletin Church outdoor sign

Number of Children Registering 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.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Gender REQUIRED Please fill out this field.
- Child's Age REQUIRED Please fill out this field. Please enter an integer (number).
- Grade entering for the UPCOMING school year 2024-2025 REQUIRED Please fill out this field.
- If your child would like to be with a friend in the same grade level, please list the friend’s name. We will do our very best to accommodate them. Please enter valid data.
- Does your child have any medical or food allergies? REQUIRED Yes No Please fill out this field.
- Please describe below
- Does your child have any emotional, physical, or learning needs/accommodations? REQUIRED Yes No Please fill out this field.
- Please explain below so we can better assist your child:
- T-Shirt Size REQUIRED Please fill out this field.
- VBS Fee (registration, t-shirt, & supplies)50.0
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.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Gender REQUIRED Please fill out this field.
- Child's Age REQUIRED Please fill out this field. Please enter an integer (number).
- Grade entering for the UPCOMING school year 2024-2025 REQUIRED Please fill out this field.
- If your child would like to be with a friend in the same grade level, please list the friend’s name. We will do our very best to accommodate them. Please enter valid data.
- Does your child have any medical or food allergies? REQUIRED Yes No Please fill out this field.
- Please describe below
- Does your child have any emotional, physical, or learning needs/accommodations? REQUIRED Yes No Please fill out this field.
- Please explain below so we can better assist your child:
- T-Shirt Size REQUIRED Please fill out this field.
- VBS Fee (registration, t-shirt, & supplies)50.0
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.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Gender REQUIRED Please fill out this field.
- Child's Age REQUIRED Please fill out this field. Please enter an integer (number).
- Grade entering for the UPCOMING school year 2024-2025 REQUIRED Please fill out this field.
- If your child would like to be with a friend in the same grade level, please list the friend’s name. We will do our very best to accommodate them. Please enter valid data.
- Does your child have any medical or food allergies? REQUIRED Yes No Please fill out this field.
- Please describe below
- Does your child have any emotional, physical, or learning needs/accommodations? REQUIRED Yes No Please fill out this field.
- Please explain below so we can better assist your child:
- T-Shirt Size REQUIRED Please fill out this field.
- VBS Fee (registration, t-shirt, & supplies)50.0
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.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Gender REQUIRED Please fill out this field.
- Child's Age REQUIRED Please fill out this field. Please enter an integer (number).
- Grade entering for the UPCOMING school year 2024-2025 REQUIRED Please fill out this field.
- If your child would like to be with a friend in the same grade level, please list the friend’s name. We will do our very best to accommodate them. Please enter valid data.
- Does your child have any medical or food allergies? REQUIRED Yes No Please fill out this field.
- Please describe below
- Does your child have any emotional, physical, or learning needs/accommodations? REQUIRED Yes No Please fill out this field.
- Please explain below so we can better assist your child:
- T-Shirt Size REQUIRED Please fill out this field.
- VBS Fee (registration, t-shirt, & supplies)50.0
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.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Gender REQUIRED Please fill out this field.
- Child's Age REQUIRED Please fill out this field. Please enter an integer (number).
- Grade entering for the UPCOMING school year 2024-2025 REQUIRED Please fill out this field.
- If your child would like to be with a friend in the same grade level, please list the friend’s name. We will do our very best to accommodate them. Please enter valid data.
- Does your child have any medical or food allergies? REQUIRED Yes No Please fill out this field.
- Please describe below
- Does your child have any emotional, physical, or learning needs/accommodations? REQUIRED Yes No Please fill out this field.
- Please explain below so we can better assist your child:
- T-Shirt Size REQUIRED Please fill out this field.
- VBS Fee (registration, t-shirt, & supplies)50.0
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.
- Date of Birth REQUIRED Please fill out this field. Please enter a date.
- Gender REQUIRED Please fill out this field.
- Child's Age REQUIRED Please fill out this field. Please enter an integer (number).
- Grade entering for the UPCOMING school year 2024-2025 REQUIRED Please fill out this field.
- If your child would like to be with a friend in the same grade level, please list the friend’s name. We will do our very best to accommodate them. Please enter valid data.
- Does your child have any medical or food allergies? REQUIRED Yes No Please fill out this field.
- Please describe below
- Does your child have any emotional, physical, or learning needs/accommodations? REQUIRED Yes No Please fill out this field.
- Please explain below so we can better assist your child:
- T-Shirt Size REQUIRED Please fill out this field.
- VBS Fee (registration, t-shirt, & supplies)50.0

Parent/Guardian Information

Father/Guardian

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

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

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Mother/Guardian

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

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

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

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.

Authorized Individuals to Pick-Up
(other than parents)

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

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

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Relationship to child: REQUIRED Please fill out this field. Please enter valid data.

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

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

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Relationship to child: REQUIRED Please fill out this field. Please enter valid data.

Emergency Contact Name
(other than parents)

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

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

Cell Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Relationship to child: REQUIRED Please fill out this field. Please enter valid data.

Mandatory Parent Meeting

For the safety of all participants, parents are required to attend ONE of the following parent meetings where we will go over drop-off/pick-up procedures and important information you will need to know for the week. Meetings dates will be announced by mid-May, and several dates will be offered to accommodate parents' schedules.

I Agree Please select this field.

Medical and Photo Release

As parent and/or legal guardian I remain legally responsible for any personal actions taken by the above named minor. I agree on behalf of myself, my child named herein, or our heirs, successors, and assigns, to hold harmless and defend the Catholic Diocese of Richmond, the Church of the Holy Family, their employees and agents, chaperones, or representatives associated with the event from any claim arising from or in connection with my child attending the event or in connection with any illness or injury (including death) or cost of medical treatment in connection therewith, and I agree to compensate the Diocese and/or Church of the Holy Family, their employees and agents and chaperones, or representatives associated with the event for reasonable attorney’s fees and expenses which may incur in any action brought against them as a result of such injury or damage, unless such claim arises from the negligence of the Diocese and/or Church of the Holy Family.

I hereby warrant that to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. In the event of any emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency, if you are unable to reach me at the above numbers I give permission for the noted emergency contact to be notified. I will not hold the Diocese of Richmond and/or the Church of the Holy Family responsible for authorizing any medical treatment beyond necessary transportation to the hospital.

I Agree Please select this field.

By checking this box you are stating and agreeing that all the above information is correct and agree to the terms listed above.

I give permission for pictures and/or video of my child(ren) (named above) engaged in activities related to the Church of the Holy Family to have their pictures posted in publications or websites. Names of participants will not be used without expressed permission from the parent or guardian. If no box is checked below, the Church of the Holy Family assumes you give permission.

Photo Release REQUIRED Yes No Please fill out this field.

Volunteers

We are in need of volunteers for the week. If you are interested, please select an area below and a staff member will contact you. All adults 18 years and older MUST BE VIRTUS-trained in accordance with diocesan safe-environment requirements. If you need VIRTUS training, please click here to register for one in our area.

Parents: Are you interested in volunteering? REQUIRED Please fill out this field.

VBS Fee (registration, t-shirt, digital download, & supplies). Choose only ONE discount if applicable.

-10.0 – 2 Child Discount

-25.0 – 3 Child discount

-45.0 – 4 or more children

Parents who can volunteer for the full duration of the program (Monday -Friday from 9:00-12:15 p.m.) will receive a $50 discount in addition to other discounts. In order qualify, parents must complete the adult volunteer form and be VIRTUS-trained by July 1, 2024.

VBS Parent Volunteer Discount (Must be able to volunteer for entire week to receive discount)

-50.0 – Parent Volunteer s

Come to the Table VBS 2024

July 22, - July 26, 2024

Monday through Friday 9:00 am to 12:15 pm

Registration fee: $50

VBS 2024 Participant Registration

Parent/Guardian Information

Mandatory Parent Meeting

Medical and Photo Release

Volunteers

Come to the Table VBS 2024

July 22, - July 26, 2024 Monday through Friday 9:00 am to 12:15 pm

Registration fee: $50

Parent/Guardian Information

Mandatory Parent Meeting

Medical and Photo Release

Volunteers

July 22, - July 26, 2024

Monday through Friday 9:00 am to 12:15 pm