VBS Pre-Registration

- Events

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).
The maximum number of form submissions has been reached. This form is currently not available.
- 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 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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Immaculate Conception Church

The Mother Church of Westerly, RI

VBS Pre-Registration