St. Pius X CATHOLIC Church

Coeur d'Alene, ID

Facebook Twitter Flocknote YouTube Instagram

VBS registration

- Please note that you will also need to read/sign our Vacation Bible School Release Form (found below). We will also have some of these forms available to sign at
  VBS check in.
- VBS Release Form
- VBS registration - please complete one per child
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Child's Gender REQUIRED Male Female Please fill out this field.
  
  Child's Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Last school grade completed: REQUIRED Please fill out this field. Please enter valid data.
  
  Name of Parent(s): REQUIRED Please fill out this field. Please enter valid data.
  
  Street 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 Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  Home church: REQUIRED Please fill out this field. Please enter valid data.
  
  Please list child's allergies, medical conditions or special needs: REQUIRED Please fill out this field.
  
  In case of emergency, contact: REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Emergency contact's relationship to child: REQUIRED Please fill out this field. Please enter valid data.
  
  Cost is $20 per FAMILY (not per child) - please only pay once if submitting multiple registrations for the same family.20.0
  
  Total:
  
  Submit
  
  Pay Now
  
  Pay Later
  
  This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.