Family Information
Información de la Familia

Last name REQUIRED Please fill out this field. Please enter valid data.

Click here to read & download the VBS Camper Liability Waiver Form.

Camper Liability Release Form REQUIRED I will download and mail or hand-deliver this form to the Ministry Center. I would like to submit this form electronically. I will watch for an email about this. Please fill out this field.

Best phone number (Use dashes, no spaces or parentheses) REQUIRED Please fill out this field. Please enter a phone number.

Email REQUIRED Please fill out this field. Please enter an email address.

Street 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 valid data.

Mother's Name (first & last) REQUIRED Please fill out this field. Please enter valid data.

Mother's Cell Phone Number (Use dashes, no spaces or parentheses) REQUIRED Please fill out this field. Please enter a phone number.

Father's Name (first & last) Please enter valid data.

Father's Cell Phone Number (Use dashes, no spaces or parentheses) Please enter a phone number.

What language do you prefer? REQUIRED English Español Please fill out this field.

Name of adult guardian on campus during VBS REQUIRED Please fill out this field. Please enter valid data.

Number of Preschoolers - Must be 3 or 4 years old by June 1 & potty-trained REQUIRED Please fill out this field.
Preschoolers 1
- First name REQUIRED Please fill out this field. Please enter valid data.
- Nickname or alternate first name for name tag REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Boy Girl Please fill out this field.
- Birth month REQUIRED Please fill out this field.
- Birth day REQUIRED
  Select one
  Please fill out this field.
- Birth year REQUIRED Please fill out this field.
- Preschool currently attending Please enter valid data.
- Allergies (leave blank if none) Please enter valid data.
- Medical conditions (leave blank if none) Please enter valid data.
- This child is enrolled in St. Norbert SUMMER Extended Day Care (Camp Norbert Jr.) REQUIRED Yes / Sí No / No Please fill out this field.
- Other important information (leave blank if none)
- ALL families are required to volunteer or provide food!
  In order to keep our costs at a minimum and get adequate support for this event, we require that each family volunteers at least 3 hours or donates food. Please check the box(es) to indicate where you are most interested in serving.
- I will:/ Voy a: REQUIRED Volunteer FULL TIME Provide food (You will be notified what food items we want you to provide.) Work one or more Prep Days (Please indicate dates below.) Please fill out this field.
- I will work the following prep days:
  Saturday, May 13, 1-4 PM Saturday, June 3, 1-4 PM Saturday, June 10, 9 AM-1 PM
- I will pay by:/Haré mi pago mediante: REQUIRED Online payment (electronic funds transfer) Credit card (transaction surcharge applies) Check* - please mail or deliver to Ministry Center Office, Attn: VBS Cash* - please deliver to Ministry Center Office Please fill out this field.
- * Please be sure to indicate name of child(ren) on check or envelope.
- First and Last Name of the person paying for Camper:
- First name REQUIRED Please fill out this field. Please enter valid data.
- Last name REQUIRED Please fill out this field. Please enter valid data.
Preschoolers 2
- First name REQUIRED Please fill out this field. Please enter valid data.
- Nickname or alternate first name for name tag REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Boy Girl Please fill out this field.
- Birth month REQUIRED Please fill out this field.
- Birth day REQUIRED
  Select one
  Please fill out this field.
- Birth year REQUIRED Please fill out this field.
- Preschool currently attending Please enter valid data.
- Allergies (leave blank if none) Please enter valid data.
- Medical conditions (leave blank if none) Please enter valid data.
- This child is enrolled in St. Norbert SUMMER Extended Day Care (Camp Norbert Jr.) REQUIRED Yes / Sí No / No Please fill out this field.
- Other important information (leave blank if none)
- ALL families are required to volunteer or provide food!
  In order to keep our costs at a minimum and get adequate support for this event, we require that each family volunteers at least 3 hours or donates food. Please check the box(es) to indicate where you are most interested in serving.
- I will:/ Voy a: REQUIRED Volunteer FULL TIME Provide food (You will be notified what food items we want you to provide.) Work one or more Prep Days (Please indicate dates below.) Please fill out this field.
- I will work the following prep days:
  Saturday, May 13, 1-4 PM Saturday, June 3, 1-4 PM Saturday, June 10, 9 AM-1 PM
- I will pay by:/Haré mi pago mediante: REQUIRED Online payment (electronic funds transfer) Credit card (transaction surcharge applies) Check* - please mail or deliver to Ministry Center Office, Attn: VBS Cash* - please deliver to Ministry Center Office Please fill out this field.
- * Please be sure to indicate name of child(ren) on check or envelope.
- First and Last Name of the person paying for Camper:
- First name REQUIRED Please fill out this field. Please enter valid data.
- Last name REQUIRED Please fill out this field. Please enter valid data.
Preschoolers 3
- First name REQUIRED Please fill out this field. Please enter valid data.
- Nickname or alternate first name for name tag REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Boy Girl Please fill out this field.
- Birth month REQUIRED Please fill out this field.
- Birth day REQUIRED
  Select one
  Please fill out this field.
- Birth year REQUIRED Please fill out this field.
- Preschool currently attending Please enter valid data.
- Allergies (leave blank if none) Please enter valid data.
- Medical conditions (leave blank if none) Please enter valid data.
- This child is enrolled in St. Norbert SUMMER Extended Day Care (Camp Norbert Jr.) REQUIRED Yes / Sí No / No Please fill out this field.
- Other important information (leave blank if none)
- ALL families are required to volunteer or provide food!
  In order to keep our costs at a minimum and get adequate support for this event, we require that each family volunteers at least 3 hours or donates food. Please check the box(es) to indicate where you are most interested in serving.
- I will:/ Voy a: REQUIRED Volunteer FULL TIME Provide food (You will be notified what food items we want you to provide.) Work one or more Prep Days (Please indicate dates below.) Please fill out this field.
- I will work the following prep days:
  Saturday, May 13, 1-4 PM Saturday, June 3, 1-4 PM Saturday, June 10, 9 AM-1 PM
- I will pay by:/Haré mi pago mediante: REQUIRED Online payment (electronic funds transfer) Credit card (transaction surcharge applies) Check* - please mail or deliver to Ministry Center Office, Attn: VBS Cash* - please deliver to Ministry Center Office Please fill out this field.
- * Please be sure to indicate name of child(ren) on check or envelope.
- First and Last Name of the person paying for Camper:
- First name REQUIRED Please fill out this field. Please enter valid data.
- Last name REQUIRED Please fill out this field. Please enter valid data.
Preschoolers 4
- First name REQUIRED Please fill out this field. Please enter valid data.
- Nickname or alternate first name for name tag REQUIRED Please fill out this field. Please enter valid data.
- Gender REQUIRED Boy Girl Please fill out this field.
- Birth month REQUIRED Please fill out this field.
- Birth day REQUIRED
  Select one
  Please fill out this field.
- Birth year REQUIRED Please fill out this field.
- Preschool currently attending Please enter valid data.
- Allergies (leave blank if none) Please enter valid data.
- Medical conditions (leave blank if none) Please enter valid data.
- This child is enrolled in St. Norbert SUMMER Extended Day Care (Camp Norbert Jr.) REQUIRED Yes / Sí No / No Please fill out this field.
- Other important information (leave blank if none)
- ALL families are required to volunteer or provide food!
  In order to keep our costs at a minimum and get adequate support for this event, we require that each family volunteers at least 3 hours or donates food. Please check the box(es) to indicate where you are most interested in serving.
- I will:/ Voy a: REQUIRED Volunteer FULL TIME Provide food (You will be notified what food items we want you to provide.) Work one or more Prep Days (Please indicate dates below.) Please fill out this field.
- I will work the following prep days:
  Saturday, May 13, 1-4 PM Saturday, June 3, 1-4 PM Saturday, June 10, 9 AM-1 PM
- I will pay by:/Haré mi pago mediante: REQUIRED Online payment (electronic funds transfer) Credit card (transaction surcharge applies) Check* - please mail or deliver to Ministry Center Office, Attn: VBS Cash* - please deliver to Ministry Center Office Please fill out this field.
- * Please be sure to indicate name of child(ren) on check or envelope.
- First and Last Name of the person paying for Camper:
- First name REQUIRED Please fill out this field. Please enter valid data.
- Last name REQUIRED Please fill out this field. Please enter valid data.

VBS Preschool Registration 2023

Family Information Información de la Familia

Family Information
Información de la Familia