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St. Rita Church 2011 VBS Registration Form

July 11 - 15, 2011  9:00 AM - Noon

Your Name:
Email Address:
Street Address:
City: State:Zip:
Future Contact: Email  Street Address
Home Phone:
Cell Phone:

Emergency Contact
E.C. Phone:

Child Name Grade ('11-'12) Birth Date
(yyyy/mm/dd)
Allergies Place with Friend
(not guaranteed)
T-shirt Size:   Child Small  Child Medium  Child Large 
Adult Small  Adult Medium
T-shirt Size:   Child Small  Child Medium  Child Large 
Adult Small  Adult Medium
T-shirt Size:   Child Small  Child Medium  Child Large 
Adult Small  Adult Medium

Teen and Adult volunteers welcome!  Please fill out this form


Number of children x $25.00
($60 family max.)
Other Comments:  


Enrollment is on a first-come basis and is limited to a maximum of 200 children.
Please make checks payable to St. Rita Church
Mail check for the total amount to

St. Rita 2011 VBS
c/o Kwiatkowski
954 Copper Kettle Road
Webster, NY 14580-8939

You should recieve confirmation that your registration has been received within 24 hours.
Enrollment is not considered complete until payment is received.

Questions can be sent to saintritavbs

Last Updated on 04/11/11 at 15:39:37 551