Registration for campers entering grades pre-k thru 5th as of 9/25&lt;br&gt;

Select number of your children attending 2025 VBS 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.
- Child Grade Entering Sept. 2025 REQUIRED Please fill out this field.
- Child Gender REQUIRED Please fill out this field.
- Does your child have allergies? REQUIRED Yes No Please fill out this field.
- If yes, please provide details. Please enter valid data.
- Does your child require medication? REQUIRED Yes No Please fill out this field.
- If yes, please provide details. (i.e., Epi pen, etc.) A separate medical consent form will be emailed for parent signature. Please enter valid data.
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.
- Child Grade Entering Sept. 2025 REQUIRED Please fill out this field.
- Child Gender REQUIRED Please fill out this field.
- Does your child have allergies? REQUIRED Yes No Please fill out this field.
- If yes, please provide details. Please enter valid data.
- Does your child require medication? REQUIRED Yes No Please fill out this field.
- If yes, please provide details. (i.e., Epi pen, etc.) A separate medical consent form will be emailed for parent signature. Please enter valid data.
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.
- Child Grade Entering Sept. 2025 REQUIRED Please fill out this field.
- Child Gender REQUIRED Please fill out this field.
- Does your child have allergies? REQUIRED Yes No Please fill out this field.
- If yes, please provide details. Please enter valid data.
- Does your child require medication? REQUIRED Yes No Please fill out this field.
- If yes, please provide details. (i.e., Epi pen, etc.) A separate medical consent form will be emailed for parent signature. Please enter valid data.
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.
- Child Grade Entering Sept. 2025 REQUIRED Please fill out this field.
- Child Gender REQUIRED Please fill out this field.
- Does your child have allergies? REQUIRED Yes No Please fill out this field.
- If yes, please provide details. Please enter valid data.
- Does your child require medication? REQUIRED Yes No Please fill out this field.
- If yes, please provide details. (i.e., Epi pen, etc.) A separate medical consent form will be emailed for parent signature. Please enter valid data.

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

Mother Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.

Mother Email Address REQUIRED Please fill out this field. Please enter valid data.

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

Father Cell Phone Number REQUIRED Please fill out this field. Please enter valid data.

Father Email Address REQUIRED Please fill out this field. Please enter valid data.

Parish belong to. REQUIRED Please fill out this field.

Emergency Contact First and 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.

Emergency Medical Consent Form: I request Resurrection Parish, 651 Millbrook Avenue, 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 and/or treatment, including, but not limited to, the use of an Epi pen, as my child may require while under the supervision of said parish 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 officers, 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/Social Media Waiver: I give my permission for the posting of photos or video on the Resurrection Parish Website and Facebook account 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/cell number for any child involved. This permission will be in effect until I request a change in writing.

I Agree Please select this field.

Resurrection Parish

651 Millbrook Ave.
Randolph, NJ
973-895-4224
973-895-4224
info @resurrectionparishnj.org

Registration for campers entering grades pre-k thru 5th as of 9/25

2025 "true north" Vacation bible School
Trusting Jesus in a wild world.

2025 Vacation Bible School registration

august 4-8, 9:00-12:30pm daily

summer vacation bible school experience what we are all about!

questions about vbs? contact us

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