Vacation Bible School (June 23-27)

June 23–27, 2025
9:00 AM – 12:00 PM
Pre-K through 5th Grade
Registration Deadline is Friday, May 30th

1 child	$50
2 children	$75
3 or more children	$90

Parent name(s) REQUIRED Please fill out this field. Please enter valid data.

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

Mailing 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.

Phone REQUIRED Please fill out this field. Please enter a phone number.

Phone (2nd) Please enter a phone number.

Would you like to assist us by volunteering at VBS? Yes

Number of children attending REQUIRED Please fill out this field.

Child information

# of children REQUIRED 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.
- Date of birth REQUIRED Please fill out this field. Please enter a date.
- Grade entering in Fall 2025 REQUIRED Please fill out this field.
- Allergies or medical conditions
  Does your child have any allergies, special needs/accommodations, learning difficulties, or medical conditions that we should know about?
- Emergency Contact(s): Provide name, relationship and phone REQUIRED Please fill out this field.
- Insurance Coverage REQUIRED My child is covered by hospitalization and medical insurance (please provide information below) My child is NOT covered by hospitalization and medical insurance and I assume responsibility for the cost of hospitalization and medical care . Please fill out this field.
- Policy Number Please enter valid data.
- Issued By: 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.
- Date of birth REQUIRED Please fill out this field. Please enter a date.
- Grade entering in Fall 2025 REQUIRED Please fill out this field.
- Allergies or medical conditions
  Does your child have any allergies, special needs/accommodations, learning difficulties, or medical conditions that we should know about?
- Emergency Contact(s): Provide name, relationship and phone REQUIRED Please fill out this field.
- Insurance Coverage REQUIRED My child is covered by hospitalization and medical insurance (please provide information below) My child is NOT covered by hospitalization and medical insurance and I assume responsibility for the cost of hospitalization and medical care . Please fill out this field.
- Policy Number Please enter valid data.
- Issued By: 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.
- Date of birth REQUIRED Please fill out this field. Please enter a date.
- Grade entering in Fall 2025 REQUIRED Please fill out this field.
- Allergies or medical conditions
  Does your child have any allergies, special needs/accommodations, learning difficulties, or medical conditions that we should know about?
- Emergency Contact(s): Provide name, relationship and phone REQUIRED Please fill out this field.
- Insurance Coverage REQUIRED My child is covered by hospitalization and medical insurance (please provide information below) My child is NOT covered by hospitalization and medical insurance and I assume responsibility for the cost of hospitalization and medical care . Please fill out this field.
- Policy Number Please enter valid data.
- Issued By: 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.
- Date of birth REQUIRED Please fill out this field. Please enter a date.
- Grade entering in Fall 2025 REQUIRED Please fill out this field.
- Allergies or medical conditions
  Does your child have any allergies, special needs/accommodations, learning difficulties, or medical conditions that we should know about?
- Emergency Contact(s): Provide name, relationship and phone REQUIRED Please fill out this field.
- Insurance Coverage REQUIRED My child is covered by hospitalization and medical insurance (please provide information below) My child is NOT covered by hospitalization and medical insurance and I assume responsibility for the cost of hospitalization and medical care . Please fill out this field.
- Policy Number Please enter valid data.
- Issued By: Please enter valid data.
Child 5
- First name REQUIRED Please fill out this field. Please enter valid data.
- Last name REQUIRED Please fill out this field. Please enter valid data.
- Date of birth REQUIRED Please fill out this field. Please enter a date.
- Grade entering in Fall 2025 REQUIRED Please fill out this field.
- Allergies or medical conditions
  Does your child have any allergies, special needs/accommodations, learning difficulties, or medical conditions that we should know about?
- Emergency Contact(s): Provide name, relationship and phone REQUIRED Please fill out this field.
- Insurance Coverage REQUIRED My child is covered by hospitalization and medical insurance (please provide information below) My child is NOT covered by hospitalization and medical insurance and I assume responsibility for the cost of hospitalization and medical care . Please fill out this field.
- Policy Number Please enter valid data.
- Issued By: Please enter valid data.
Child 6
- First name REQUIRED Please fill out this field. Please enter valid data.
- Last name REQUIRED Please fill out this field. Please enter valid data.
- Date of birth REQUIRED Please fill out this field. Please enter a date.
- Grade entering in Fall 2025 REQUIRED Please fill out this field.
- Allergies or medical conditions
  Does your child have any allergies, special needs/accommodations, learning difficulties, or medical conditions that we should know about?
- Emergency Contact(s): Provide name, relationship and phone REQUIRED Please fill out this field.
- Insurance Coverage REQUIRED My child is covered by hospitalization and medical insurance (please provide information below) My child is NOT covered by hospitalization and medical insurance and I assume responsibility for the cost of hospitalization and medical care . Please fill out this field.
- Policy Number Please enter valid data.
- Issued By: Please enter valid data.
Child 7
- First name REQUIRED Please fill out this field. Please enter valid data.
- Last name REQUIRED Please fill out this field. Please enter valid data.
- Date of birth REQUIRED Please fill out this field. Please enter a date.
- Grade entering in Fall 2025 REQUIRED Please fill out this field.
- Allergies or medical conditions
  Does your child have any allergies, special needs/accommodations, learning difficulties, or medical conditions that we should know about?
- Emergency Contact(s): Provide name, relationship and phone REQUIRED Please fill out this field.
- Insurance Coverage REQUIRED My child is covered by hospitalization and medical insurance (please provide information below) My child is NOT covered by hospitalization and medical insurance and I assume responsibility for the cost of hospitalization and medical care . Please fill out this field.
- Policy Number Please enter valid data.
- Issued By: Please enter valid data.
Child 8
- First name REQUIRED Please fill out this field. Please enter valid data.
- Last name REQUIRED Please fill out this field. Please enter valid data.
- Date of birth REQUIRED Please fill out this field. Please enter a date.
- Grade entering in Fall 2025 REQUIRED Please fill out this field.
- Allergies or medical conditions
  Does your child have any allergies, special needs/accommodations, learning difficulties, or medical conditions that we should know about?
- Emergency Contact(s): Provide name, relationship and phone REQUIRED Please fill out this field.
- Insurance Coverage REQUIRED My child is covered by hospitalization and medical insurance (please provide information below) My child is NOT covered by hospitalization and medical insurance and I assume responsibility for the cost of hospitalization and medical care . Please fill out this field.
- Policy Number Please enter valid data.
- Issued By: Please enter valid data.

Archdiocesan Permission and Waiver Agreement

Your child has the opportunity to participate in a voluntary Faith Formation experience as follows:

Program location: Sacred Heart Parish
Day of the Week: Monday – Friday
Time: 9:00 AM – 12:00 PM
Dates: June 23 – June 27, 2025
Parish Contact/Emergency Number to contact Parish during program: 410-833-1696
This faith formation program is entirely voluntary. Participation requires that you, as parent or legal guardian, give written permission for your child(ren) to participate in this activity and accept risks associated with this program by signing and returning this Permission and Waiver Agreement at the time of registration. If the signed Permission and Waiver Agreement is not submitted, your child(ren) will not be able to participate in the faith formation program.
Archdiocesan Permission and Waiver Agreement

I CERTIFY THAT I AM THE PARENT OR LEGAL GUARDIAN OF THE ABOVE-NAMED CHILD(REN), HAVE READ THE FOREGOING AGREEMENT, UNDERSTAND THAT I GIVE UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT VOLUNTARILY.

I Agree (my check mark is my signature) Please select this field.

Sacred Heart Parish

Catholic church - glyndon, md

Vacation Bible School (June 23-27)

Contact Us

VBS 2025 Registration

Child information