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VBS

2024



This is the registration for the 2024 Vacation Bible School hosted by Holy Cross. Due to the generosity of diocesan scholarships and our wonderful volunteers, there will be no charge to participate in our VBS this summer. If you would like to donate, online or in-person giving to Holy Cross is always appreciated. We are looking forward to a great week! For more information, please contact Jennifer Kirshner at jkirshner@dioceseofgreensburg.org.  ALL REGISTRATIONS ARE DUE BY JUNE 3 AND MUST BE COMPLETED BY THIS DATE. Any registrations submitted after June 3 will not be accepted.

When - June 17 to June 21, 6:00 p.m. to 8:00 p.m.

Where - Holy Cross Church, Youngwood

Who - Children in Pre-K (4 yrs. old) to 5th grade




Below, please select "Minor(s)" and the number of children you are registering...
Minor(s)
1 Minor2 Minors3 Minors4 Minors5 MinorsMore Minors6 Minors7 Minors8 Minors9 Minors10 Minors
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First Child's Name

First Name*

Middle Name

Last Name*
First Child's Date of Birth*
First Child's Signature*
Second Child's Name

First Name*

Middle Name

Last Name*
Second Child's Date of Birth*
Third Child's Name

First Name*

Middle Name

Last Name*
Third Child's Date of Birth*
Fourth Child's Name

First Name*

Middle Name

Last Name*
Fourth Child's Date of Birth*
Fifth Child's Name

First Name*

Middle Name

Last Name*
Fifth Child's Date of Birth*
Sixth Child's Name

First Name*

Middle Name

Last Name*
Sixth Child's Date of Birth*
Seventh Child's Name

First Name*

Middle Name

Last Name*
Seventh Child's Date of Birth*
Eighth Child's Name

First Name*

Middle Name

Last Name*
Eighth Child's Date of Birth*
Ninth Child's Name

First Name*

Middle Name

Last Name*
Ninth Child's Date of Birth*
Tenth Child's Name

First Name*

Middle Name

Last Name*
Tenth Child's Date of Birth*
Child's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Additional Information

In addition to the listed emergency contact, please list any additional people and their phone numbers who you would like the VBS volunteers to have. These could also be used in case of an emergency or for extra contact people.

Is there any additional information that we need to know about your child(ren) before VBS begins?

If there are any food allergies or allergies to medication with your child(ren), please list them below.

Photo Release (via Diocese of Greensburg website)

By signing this waiver, I hereby grant the Diocese of Greensburg, Pennsylvania, and its respective licensees (Holy Cross), successors and assigns, the right and permission, with respect to those photographs taken of the minor named below on whose behalf I am signing, and with respect to any printed or electronic matter in connection therewith, to do the following:

1.To include such photographs on websites within the Diocese of Greensburg and social media sites, and on print material.

2.To use my name, or the name of the minor on whose behalf I am signing, in connection with the foregoing.

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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