• Use this form to pre-register for VBS at Immaculate now! Registration is finalized upon receipt of payment ($15 for the first child; $20 for the entire family; ask to speak with Fr. Capoverdi if your family requires a scholarship).
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  • Name, Age, and Sex of Child 1: REQUIRED Please fill out this field.
  • Name, Age, and Sex of Child 2:
  • Name, Age, and Sex of Child 3:
  • Name, Age, and Sex of Child 4:
  • Name, Age, and Sex of Child 5:
  • Name, Age, and Sex of Child 6:
  • Name, Age, and Sex of Child 7:
  • Information
    • Street Address (Street, City, State, and Zip) REQUIRED Please fill out this field.
    • Primary Phone REQUIRED Please fill out this field. Please enter valid data.
    • Secondary Phone Please enter valid data.
    • Primary eMail Please enter an email address.
    • Secondary eMail Please enter an email address.
    • Will parents be helping in any areas of VBS? REQUIRED (Select One) Maybe, Please Contact Me Yes No Please fill out this field.
    • If so, how? Please enter an email address.
    • Home Parish REQUIRED Please fill out this field. Please enter valid data.
    • Any special requests (such as friends to pair with your child(ren)
  • Emergency
    • In case of emergency, contact: REQUIRED Please fill out this field. Please enter valid data.
    • Emergency Phone REQUIRED Please fill out this field. Please enter valid data.
    • Allergies or other medical conditions (enter "None" if not applicable) REQUIRED Please fill out this field.

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