(318) 487-9894/Fax: (318) 445-0436

9323 Highway 165 South ~ Woodworth, LA

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Vacation Bible School

VBS Registration Form
Mary, Mother of Jesus Church, Woodworth
June 5-9, 2022 8:00AM-11:30AM

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If you prefer, you may download the form and return the the completed form to the Office.

Registration Fee:  Parishioners Free - All others: $25 per family

By submitting this form, you agree to allow VBS leaders to photograph/film the child registered below in any matter related to the VBS Program.

Child's Name
Grade Completed
Date of Birth
Parents' Names
Address, City/State, Zip
Child's T-Shirt Size
Email Address
Phone where Parents can be reached
People Who May Pick Up Child
Allergies / Medical Concerns
Permission to photograph/film the minor designated above in any matter related to the VBS Program
Yes
No
Checking this box will serve as Parent Signature*
I Agree
Submit


MARY MOTHER OF JESUS CATHOLIC CHURCH
9323 Highway 165 South - P. O. Box 408,
Woodworth, Louisiana 71485
Phone - (318) 487-9894 / Fax - (318) 445-0436

 

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