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VBS Summer Camp Registration

- please read carefully:
  
  Registration will close May 31 or when all spots are filled, whichever comes first.
  In the form below, grade levels that have a (0) after them are full. We are not able to accept names for the waiting list.
  VBS Summer Camp is being held in the school building located on the AGP Saint Malachy Campus. The address is 343 Forest Grove Road, Coraopolis, 15108.
  VBS begins at 9:00 AM and ends at 12:00 PM. In the morning, please drop off your child in the Youth Ministry Center between 8:45 and 9:00 AM. Please do not drop off children before 8:45 AM.
  Please use the cafeteria entrance in the rear of the building to enter and exit the facilities.
  Parents/Guardians must drop off and pick up their children inside the YMC each day. Parents/Guardians must enter the building to sign in and sign out their child. Campers cannot be dismissed to the parking lot.
  Campers are assigned to a crew based on which grade level they are completing in spring of 2026. We can no longer accept requests for crew assignments. Please do not email us asking for you child to be placed in a crew with another child.
  Campers should wear tennis shoes each day as we will be playing in the gym. Please do not have your child wear flip flops or sandals.
  Campers will receive a t-shirt which they are encouraged to wear throughout the week.
- VBS Summer Camp Registration
  
  The maximum number of form submissions has been reached. This form is currently not available.
  
  Acknowledgement of VBS Information REQUIRED I have carefully read and understand the information above. Please fill out this field.
  
  Family Information
  
  Our family is registered with: REQUIRED Please fill out this field.
  
  Mother's Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Mother's 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.
  
  Mother's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Mother's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Father's Information
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Father's 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.
  
  Father's Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Father's Email REQUIRED Please fill out this field. Please enter an email address.
  
  Emergency Contact Information (In case we cannot reach parent/guardian)
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name 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.
  
  List the names of persons, other than a parent/guardian, who are authorized to pick up your child along with their relationship to the child (example: Jane Smith, grandmother) REQUIRED Please fill out this field.
  
  How many children are you registering? REQUIRED Please fill out this field.
  
  Child 1
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Child 2
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Child 3
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Child 4
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Child 5
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Child 6
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Child 7
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Child 8
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Child 9
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Child 10
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Birth date REQUIRED Please fill out this field. Please enter a date.
  
  Age at the time of VBS REQUIRED Please fill out this field. Please enter an integer (number).
  
  Gender REQUIRED Please fill out this field.
  
  Grade level COMPLETING in spring 2026 REQUIRED Please fill out this field.
  
  Confirm the grade level your child is COMPLETING in the spring of 2026 (this field must match the previous field or your registration will not be processed). REQUIRED Please fill out this field.
  
  T-shirt Size REQUIRED Please fill out this field.
  
  Please list any allergies, medical conditions, or special learning needs. REQUIRED Please fill out this field.
  
  Publicity Consent and Authorization
  
  Permission is hereby granted to Archangel Gabriel Parish to use photographs, films/video, quotations, and/or voice recording of the above named child(ren) to assist in its community awareness, educational efforts, and related publicity purposes. It is hereby stipulated that such use of said photographs, films/video, quotations, and/or voice recordings will not violate the rights of the named individual, his/her legal representatives, nor his/her respective heirs, and I do hereby indemnify and hold harmless any agents, servants, employees, and/or representatives of the Archangel Gabriel Parish from any and all claims, demands, and/or causes of action of whatever kind or nature arising from the use of photographs, films/videos, quotations, and/or voice recordings or their actions taken pursuant to this authority. I further agree that I waive any right to compensation, fee, or royalty for myself, my successors, heirs, or assigns for the production or use of the aforesaid materials. Further, it is hereby stipulated and agreed that Archangel Gabriel Parish will not incur any liability for payment to any person or organization as a result of the stated use of the aforesaid photographs, films/video, quotations, and/or voice recordings of the named individual.
  
  Publicity Consent and Authorization REQUIRED I agree Please fill out this field.
  
  Payment for VBS Registration REQUIRED
  How many children are you registering?
  Please fill out this field.
  
  Email of person completing this form REQUIRED Please fill out this field. Please enter an email address.
  
  Total:
  
  Submit
  
  Proceed to Payment