St. Mary Magdalen

Catholic Church, Diocese of Wilmington

7 Sharpley Road
Wilmington, Delaware 19803
Phone: 302-652-6800

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VBS Registration

- RELIGIOUS ED
  - PREP CLASSES
    
    Registration & Tuition
    Classroom - Pre-K
    Classroom - Grades K-8
    PREP News & Lessons
  - FAITH FORMATION
    
    Resources
    Vacation Bible School
    VBS Registration

June 12 - June 16, 2023
9:15AM - 12:15PM Daily
2023 VBS Online Registration
The maximum number of form submissions has been reached. This form is currently not available.
- Family's Last Name REQUIRED Please fill out this field. Please enter valid data.
- Number of Children Attending REQUIRED Please fill out this field.
- Event Specific Consent and Release
  
  My child has my permission to attend Vacation Bible School to be held at St. Mary Magdalen Parish on June 12, 2023 - June 16, 2023 from 915am to 12:15pm. I hereby give my permission for my child to attend said event and I understand that my child will be chaperoned by responsible cleared adults. I understand that this parish/school, CYM, the Diocese of Wilmington, and its staff are committed to providing fun, safe, educational experiences and that such events are conducted in smoke-, alcohol-, and drug-free environments. In light of this, and to help ensure the safety of all concerned, I understand that if my child is in possession of drugs, alcohol, or tobacco products, engages in illegal, immoral, or offensive behaviors, or refuses to follow the directions given by staff or volunteers while participating in this activity, I will be contacted immediately to pick up my child. As parent/guardian, I understand that promotional pictures (individual and group) will be taken during this event. I give permission for my son’s/daughter’s picture to be used for promotional materials (newsletter, web page, calendars, power point, etc.) in highlighting the event.
  
  By checking off the box below, I release the staff of St. Mary Magdalen Parish, CYM staff, additional chaperons, and the Diocese of Wilmington from any and all liabilities and waive all claims against them. I also give my permission for the group leader and other qualified cleared adults to obtain proper medical treatment for my child should it become necessary.
  I Agree to the Event Specific Consent & Release above. Please select this field.
- VBS Paricipant Information:
  
  In the space below please list the requested info. Example:
  Suzie Snowflake, 10/2/2012, 4th grade
  Sally Snowflake, 7/12/2014, 2nd grade
- Full Name(s), Date(s) of birth, Grade(s) for fall 2023 of Child(ren) REQUIRED Please fill out this field.
- Parent Contact Information:
- Parent Full Name REQUIRED Please fill out this field. Please enter valid data.
- Parent Email REQUIRED Please fill out this field. Please enter an email address.
- Parent 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.
- Parent Home Phone Maximum 20 characters Please enter a phone number.
- Parent Cell Phone REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Parent Work Phone Maximum 20 characters Please enter a phone number.
- Emergency Contact name (other than parent), relationship to child & phone # REQUIRED Please fill out this field. Please enter valid data.
- Providing email address and cell number grants permission for electronic communication in accord with diocesan guidelines. In case of an emergency, we will call your cell phone first, then your home phone, then the work number given. If unable to reach you, we will then reach out to the emergency contact listed.
- Medical Information:
- Family Doctor Name & Phone REQUIRED Please fill out this field. Please enter valid data.
- Family Dentist Name & Phone REQUIRED Please fill out this field. Please enter valid data.
- Insurance Carrier / Policy # REQUIRED Please fill out this field. Please enter valid data.
- Insurance Company Phone # REQUIRED Please fill out this field. Please enter valid data.
- Prescription meds taken regularly Please enter valid data.
- Other medication taken regularly Please enter valid data.
- Any food, medication, latex allergies? REQUIRED Please fill out this field.
- If your child has a food allergy and requires an epi-pen, please check in with the snack leader. If necessary provide a different snack for your child, and an epi-pen for the crew leader with your child's name on it, if needed.
- Is the young person(s) allergic to bee stings? REQUIRED Please fill out this field.
- VBS Registration Fee REQUIRED Please fill out this field.
- If you answered yes to the questions above, list child's name and specific allergy
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