9408 Wilson Ave SW, Byron Center, Mi 49315

(616) 878-1619

Email: parishoffice@stsebastianmi.org

VBS Family Registration Form

2024 SCUBA VBS Family Registration Form (one per family)

Are you members of St. Sebastian Church?(Required)

Child Registration

Please fill out below for each child you are registering. We will be grouping children more by age this year. So we will not be taking requests to be with certain friends.
Child 1 Name(Required)
Child 2 Name
Child 3 Name
Child 4 Name
Child 5 Name

Parent/Guardian Information

Parent/Guardian 1 Name(Required)
Parent/Guardian 2 Name
Please provide an email address to receive correspondence regarding VBS.
Please provide a phone number you will have with you during VBS times in case we need to reach you for any reason.
Please provide an alternative phone number in case we are unable to reach you at the primary phone number.
As legal guardian, I understand that photos and videos of participants may be taken during this time. I am the parent/guardian of those listed on this sheet, and I hereby approve and consent to the use of his/her photo or video image and name to be used for promotional purposes (bulletin, church website, newspaper, etc.).
As a parent/legal guardian, I do hereby authorize the treatment for the children listed on this form in the event of an emergency which may endanger his/her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after a reasonable effort has been made to reach me at the telephone numbers listed on this form. I agree to be responsible for all costs and expenses incurred in connection with said medical services. This is intended for the period of June 23-27 during St. Sebastian Parish Vacation Bible School. I understand that all reasonable safety precautions will be taken at all times by the parish and its agents during VBS. I agree not to hold St. Sebastian Parish, its leaders, employees, volunteers, or the Roman Catholic Diocese of Grand Rapids liable for damages, losses, diseases, or injuries incurred by the aforementioned.
Please provide the name, relationship to, and phone number for emergency contact person.