2023 Vacation Bible School (VBS)
for grades entering K-5 in the fall

2023 Vacation Bible School
"Stellar" shine jesus' light!
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  Prmary Parent Contact - First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Parent Contact - Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Parent Email REQUIRED Please fill out this field. Please enter an email address.
  
  Re-enter Primary Parent Contact Email REQUIRED Please fill out this field. Please enter an email address.
  
  Primary Parent Contact Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Primary Parent Contact Home Phone (If applicable) Please enter valid data.
  
  Emergency Contact First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Relationship REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Cell Phone REQUIRED Please fill out this field. Please enter valid data.
  
  Emergency Contact Home Phone (If applicable) Please enter valid data.
  
  Select number of children you are 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.
  
  Parish child belongs to. REQUIRED Please fill out this field.
  
  Child Grade Entering Sept. 2023 REQUIRED Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Does your child have allergies? REQUIRED Please fill out this field.
  
  If yes, please provide details. REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child require medication? REQUIRED Please fill out this field.
  
  If yes, please provide details. (Epi pen, etc.) REQUIRED Please fill out this field. Please enter valid data.
  
  *If your chlid requires medication, you will be emailed subsequent instructions for providing us with a medical note from his/her physcian prior to attending VBS.
  
  EMERGENCY MEDICAL CONSENT I request Resurrection Parish at 651 Millbrook Ave., Randolph, NJ 07869, to accept my child into its Vacation Bible School. I do hereby give permission to the personnel (parish staff and volunteers) of Resurrection Parish to administer, secure and/or authorize such emergency medical care from parishi personnel. I also agree to pay all costs and fees related to said emergency medical care. I release, hold harmless and discharge Resurrection Parish, its offices, employees and personnel from any and all liability, claims, losses, damages, costs, and/or expenses resulting from said emergency medical care, including, but not limited to, the use of an Epi pen.
  I Agree Please select this field.
  
  WEBSITE PHOTO/VIDEO WAIVER I give my permission for the posting of photos or video on the Resurrection Parish Website that may contain my son/daughter. Photos/video may include a caption describing the activity. Photos or video will not contain the last name, home address, or telephone number for my child involved. This permission will be in effect until I request a change in writing.
  I Agree Please select this field.
  
  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.
  
  Parish child belongs to. REQUIRED Please fill out this field.
  
  Child Grade Entering Sept. 2023 REQUIRED Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Does your child have allergies? REQUIRED Please fill out this field.
  
  If yes, please provide details. REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child require medication? REQUIRED Please fill out this field.
  
  If yes, please provide details. (Epi pen, etc.) REQUIRED Please fill out this field. Please enter valid data.
  
  *If your chlid requires medication, you will be emailed subsequent instructions for providing us with a medical note from his/her physcian prior to attending VBS.
  
  EMERGENCY MEDICAL CONSENT I request Resurrection Parish at 651 Millbrook Ave., Randolph, NJ 07869, to accept my child into its Vacation Bible School. I do hereby give permission to the personnel (parish staff and volunteers) of Resurrection Parish to administer, secure and/or authorize such emergency medical care from parishi personnel. I also agree to pay all costs and fees related to said emergency medical care. I release, hold harmless and discharge Resurrection Parish, its offices, employees and personnel from any and all liability, claims, losses, damages, costs, and/or expenses resulting from said emergency medical care, including, but not limited to, the use of an Epi pen.
  I Agree Please select this field.
  
  WEBSITE PHOTO/VIDEO WAIVER I give my permission for the posting of photos or video on the Resurrection Parish Website that may contain my son/daughter. Photos/video may include a caption describing the activity. Photos or video will not contain the last name, home address, or telephone number for my child involved. This permission will be in effect until I request a change in writing.
  I Agree Please select this field.
  
  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.
  
  Parish child belongs to. REQUIRED Please fill out this field.
  
  Child Grade Entering Sept. 2023 REQUIRED Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Does your child have allergies? REQUIRED Please fill out this field.
  
  If yes, please provide details. REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child require medication? REQUIRED Please fill out this field.
  
  If yes, please provide details. (Epi pen, etc.) REQUIRED Please fill out this field. Please enter valid data.
  
  *If your chlid requires medication, you will be emailed subsequent instructions for providing us with a medical note from his/her physcian prior to attending VBS.
  
  EMERGENCY MEDICAL CONSENT I request Resurrection Parish at 651 Millbrook Ave., Randolph, NJ 07869, to accept my child into its Vacation Bible School. I do hereby give permission to the personnel (parish staff and volunteers) of Resurrection Parish to administer, secure and/or authorize such emergency medical care from parishi personnel. I also agree to pay all costs and fees related to said emergency medical care. I release, hold harmless and discharge Resurrection Parish, its offices, employees and personnel from any and all liability, claims, losses, damages, costs, and/or expenses resulting from said emergency medical care, including, but not limited to, the use of an Epi pen.
  I Agree Please select this field.
  
  WEBSITE PHOTO/VIDEO WAIVER I give my permission for the posting of photos or video on the Resurrection Parish Website that may contain my son/daughter. Photos/video may include a caption describing the activity. Photos or video will not contain the last name, home address, or telephone number for my child involved. This permission will be in effect until I request a change in writing.
  I Agree Please select this field.
  
  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.
  
  Parish child belongs to. REQUIRED Please fill out this field.
  
  Child Grade Entering Sept. 2023 REQUIRED Please fill out this field.
  
  Gender REQUIRED Male Female Please fill out this field.
  
  Does your child have allergies? REQUIRED Please fill out this field.
  
  If yes, please provide details. REQUIRED Please fill out this field. Please enter valid data.
  
  Does your child require medication? REQUIRED Please fill out this field.
  
  If yes, please provide details. (Epi pen, etc.) REQUIRED Please fill out this field. Please enter valid data.
  
  *If your chlid requires medication, you will be emailed subsequent instructions for providing us with a medical note from his/her physcian prior to attending VBS.
  
  EMERGENCY MEDICAL CONSENT I request Resurrection Parish at 651 Millbrook Ave., Randolph, NJ 07869, to accept my child into its Vacation Bible School. I do hereby give permission to the personnel (parish staff and volunteers) of Resurrection Parish to administer, secure and/or authorize such emergency medical care from parishi personnel. I also agree to pay all costs and fees related to said emergency medical care. I release, hold harmless and discharge Resurrection Parish, its offices, employees and personnel from any and all liability, claims, losses, damages, costs, and/or expenses resulting from said emergency medical care, including, but not limited to, the use of an Epi pen.
  I Agree Please select this field.
  
  WEBSITE PHOTO/VIDEO WAIVER I give my permission for the posting of photos or video on the Resurrection Parish Website that may contain my son/daughter. Photos/video may include a caption describing the activity. Photos or video will not contain the last name, home address, or telephone number for my child involved. This permission will be in effect until I request a change in writing.
  I Agree Please select this field.
  
  Submit
  
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- august 7-11, 9:00-12:30pm daily
- summer vacation bible school experience what we are all about!
- questions about vbs? contact us
  
  Lscandariato@resurrectionparishnj.org
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2023 Vacation Bible School (VBS)for grades entering K-5 in the fall

2023 Vacation Bible School (VBS)
for grades entering K-5 in the fall