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2025 Vacation Bible School

Monday, June 16- Friday, June 20, 2025

9 a.m. to noon at Our Lady of Grace Church 

Registration is required for participation in Vacation Bible School. It is mandatory for us to have the family's contact information, health concerns, and signed waivers on file for you to leave your child in our care. A family may register all of their children (PK-5th) or Teen Helpers on one waiver. 

REGISTRATION DEADLINE

Monday, June 9

or

until capacity of 110 participants has been met

*please note the your registration is not complete until

you have verified the waiver

(you will receive a verification email once you submit the waiver and you need to click the link)

and submitted the payment.

We do not turn anyone away due to inability to pay.

If your family's current situation impacts your ability to pay the registration,

please contact one of the Event Supervisors.

Your privacy is respected.

PARISH NAME: Our Lady of Grace & St. Benedict 

PARISH ADDRESS: 1011 Mount Pleasant Road Greensburg, PA 15601

EVENT SUPERVISOR: 

  Stephanie McCarthy 724-838-9480 x 17 or

 Katrina Coleman724-838-9480 x 16

EVENT: Vacation Bible School

TRANSPORTATION: NONE

REGISTRATION DONATION: 

   EARLY BIRD REGISTRATION DONATION (Through May 12)
   https://www.osvhub.com/ourlady-of-grace-church/forms/2025vbsearlybird

    1 Child: $10             2 Children: $18             3+ Children: $25

   REGULAR REGISTRATION DONATION (May 13-June 09)
   https://www.osvhub.com/ourlady-of-grace-church/forms/2025vbs

   1 Child: $15             2 Children: $28             3+ Children: $35

Donations can be made online, in cash, or by check*

To pay by cash or check, place your payment in an envelope labeled ATTN:ITZIA-VBS Payment and:

  • drop it off at the Our Lady of Grace or Saint Benedict Parish Office during office hours
  • drop it, if after office hours, in the black drop box by the front office door at Our Lady of Grace Parish or Saint Benedict Parish Center
  • drop it in the weekend collection basket at Our Lady of Grace or Saint Benedict
  • mail it to Our Lady of Grace Church, ATTN: VBS, 1011 Mount Pleasant Road Greensburg PA 15601
  • drop it off at the Welcome Center at Our Lady of Grace Church

*All checks should be made payable to Our Lady of Grace Church

To pay online:

  • click one of the payment links above
  • use the VBS Donation link on parish webpage of Our Lady of Grace or Saint Benedict Parish


2025 VBS FAMILY PICNIC, Friday, June 20, at noon
After our closing celebration at 11:45 a.m. on Friday, we invite participants and their families to a picnic. The parish provides a cookout of hamburgers, hot dogs, and beverages. Each family is asked to bring a side dish, fruits, veggies, or a dessert to share. 

To order the correct amount of food, we ask that all families RSVP for the picnic with the number of guests and the total number of hot dogs and/or hamburgers their family will eat. If you want to RSVP now, you can do so at: https://forms.gle/WyhexvozLUcieSh6A  We will also send this link in VBS Flocknote messages.


CONSENT TO PARTICIPATE

I hereby consent to participation for the named child(ren) in the event described above. I understand that if stated, this event will take place away from the Church grounds and that my child(ren) will be under the supervision of the designated parish employee on the stated date(s). I further consent to the conditions stated above on participation in this event, including the method of transportation. In case of emergency, we give permission for our child(ren) to be treated at a hospital and/or by a medical doctor.

In consideration for providing my child(ren) the opportunity to attend formation and parish activities and any related transportation to and from the parish, both my child(ren) and I voluntarily agree to release and agree to hold PARISH AND DIOCESE OF GREENSBURG harmless from, and waive on behalf of myself/my child(ren), my heirs, and any personal representatives, any and all causes of action, claims, demands, damages, costs, expenses and compensation for damage or loss to myself/my child(ren) that may be caused by any act, or failure to act of the PARISH AND DIOCESE OF GREENSBURG or that may otherwise arise in any way in connection with my child(ren)’s attendance at a parish/diocesan event to the fullest extent allowed by law.

I understand that this release discharges the PARISH, AND DIOCESE OF GREENSBURG from any liability or claim that I/my child(ren), my heirs, or any personal representatives may have against the parish/ diocese with respect to any bodily injury, illness, death, or medical treatment that may arise from, or in connection to, my child(ren)’s attendance at the parish or event.

This liability waiver and release extends to the PARISH, AND DIOCESE OF GREENSBURG together with its clergy, staff, and volunteers.

I certify and represent that I have the legal authority to waive, discharge, release, and hold harmless the released parties on behalf of myself and the above-named student.


Date: May 1, 2025

* Crew assignments are based on birthdates and the number of participants in an age group. Therefore, we are unable to accommodate requests for friends to be placed together.  


Photographic Release

PHOTOGRAPHIC RELEASE LETTER

I hereby grant to the Diocese of Greensburg, Pennsylvania, and its respective licensees, 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: To include such photographs on the Diocese of Greensburg website and on print material (names of minors are not used for web or print media/publications without prior consent)

I hereby release, discharge and agree to indemnify and hold harmless the Diocese of Greensburg and its legal representatives, licensees, successor and assigns, from all claims and demands whatsoever arising out of or in connection with the foregoing, and waive any right to inspect or approve the same.

I hereby certify that I am the parent and/or guardian of the above said minor/s under the age of eighteen years, and hereby consent on behalf of said minor to the use of any of the photographs taken of said minor pursuant to the terms set forth in this Photographic Release, including, without limitation, the release, discharge and hold harmless provisions thereof.

Click to customize checkboxes *
I AGREE to the Photographic Release
I DO NOT AGREE to the Photographic Release
First Child's Name

First Name*

Last Name*

Phone*
First Child's Date of Birth*
First Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
First Child's Signature*
Second Child's Name

First Name*

Last Name*
Second Child's Date of Birth*
Second Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
Third Child's Name

First Name*

Last Name*
Third Child's Date of Birth*
Third Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
Fourth Child's Name

First Name*

Last Name*
Fourth Child's Date of Birth*
Fourth Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
Fifth Child's Name

First Name*

Last Name*
Fifth Child's Date of Birth*
Fifth Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
Sixth Child's Name

First Name*

Last Name*
Sixth Child's Date of Birth*
Sixth Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
Seventh Child's Name

First Name*

Last Name*
Seventh Child's Date of Birth*
Seventh Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
Eighth Child's Name

First Name*

Last Name*
Eighth Child's Date of Birth*
Eighth Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
Ninth Child's Name

First Name*

Last Name*
Ninth Child's Date of Birth*
Ninth Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
Tenth Child's Name

First Name*

Last Name*
Tenth Child's Date of Birth*
Tenth Child's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
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*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Insurance

Insurance Carrier*

Insurance Policy Number*
Father/Primary Guardian Information

First Name

Last Name

Address (if different from Participant)

Email

Home Phone (if different from participant)

Cell Phone
Is this the primary adult contact?*
No
Yes
Mother/Primary Guardian Information

First Name

Last Name

Address (if different from Participant)

Email

Home Phone (if different from Participant)

Cell Phone
Is this the primary adult contact?*
No
Yes
Custody/Divorce/Separation Situations

Are there any concerns/situations that we should be aware of pertaining to the safety/security of this child?

Is there anyone who is NOT permitted to be with your child?
Are you interested in helping?
I would like to.....(please check all that apply) Please note: all on-site helpers 18 years of age and older must complete Diocesan and State Clearances & Trainings.
Decorating Team
Material Preparation (at home)
Setup
Crew Leader
Crew Helper
Clean-up
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*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Grade Child (Teen Helper) is entering in Fall 2025*
My parish of registration is:*
Our Lady of Grace
Saint Benedict
Other

If other, what is your parish of registration?
My child has a food allergy*
No
Yes

If answered yes to food allergy, please list the allergies and be specific. (i.e.: Milk allergy: can eat food with milk in it; cannot drink glass of milk)
My child has a non-food allergy:*
No
Yes

If yes, please list the allergy/allergies:
My child has a learning disability*
No
Yes

If answered yes to learning disability, please list ALL learning disabilities
My child has a medical condition*
No
Yes

If answered yes to medical condition, please list ALL medical conditions

Please list any special accommodations that your child may need
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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