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Sacred Heart Parish
Spencer, Iowa
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Home
About
Our Church
Mass Times
Bulletins
Bulletin Advertisers
Parish Registration
Parish History
Who We Are
Staff
Contact Us
Sacraments
Baptism Information Form
Worship & Music
Online Mass
Mass Readings and Intentions
Liturgical Ministries
Music
Faith Formation
Advent
Youth Faith Formation
Adult Faith Formation
Adoration
RCIA
FORMED
VIRTUS
Giving
Church Support
Planned Giving
Charitable Gift Annuities
Amazon Smile
Fall Gala
Monsignor Lafferty Tuition Foundation- MLTF
Scrip
Annual Financial Reports
Parish Life
Prayer Shawl
Rosary Makers
Parish Rosary Weekends
Knights of Columbus
Catholic Daughters
Prayer Chain
Weddings
Funerals
News & Events
News and Events
Parish Calendar
Birthdays & Anniversaries
Sacred Heart 150th Celebration
Pre-K Summer VBS Registration
Faith Formation
Advent
Youth Faith Formation
Registration Form 2022-2023
Adult Faith Formation
Adoration
RCIA
FORMED
VIRTUS
This VBS will be for students entering PreK (ages 4 and 5) or students who were not yet 5 for the June VBS.
The program is limited to students who are from Sacred Heart Parish or School families.
2022 Pre-K Summer VBS Registration Form
The maximum number of form submissions has been reached. This form is currently not available.
# of children to register
REQUIRED
Please fill out this field.
Registration 1
Child's Name
REQUIRED
Please fill out this field.
Please enter valid data.
Gender
REQUIRED
Male
Female
Please fill out this field.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
Grade completed
REQUIRED
Please fill out this field.
Please enter valid data.
Allergies or medical conditions
REQUIRED
Please fill out this field.
Please enter valid data.
Registration 2
Child's Name
REQUIRED
Please fill out this field.
Please enter valid data.
Gender
REQUIRED
Male
Female
Please fill out this field.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
Grade completed
REQUIRED
Please fill out this field.
Please enter valid data.
Allergies or medical conditions
REQUIRED
Please fill out this field.
Please enter valid data.
Registration 3
Child's Name
REQUIRED
Please fill out this field.
Please enter valid data.
Gender
REQUIRED
Male
Female
Please fill out this field.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
Grade completed
REQUIRED
Please fill out this field.
Please enter valid data.
Allergies or medical conditions
REQUIRED
Please fill out this field.
Please enter valid data.
Registration 4
Child's Name
REQUIRED
Please fill out this field.
Please enter valid data.
Gender
REQUIRED
Male
Female
Please fill out this field.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
Grade completed
REQUIRED
Please fill out this field.
Please enter valid data.
Allergies or medical conditions
REQUIRED
Please fill out this field.
Please enter valid data.
Registration 5
Child's Name
REQUIRED
Please fill out this field.
Please enter valid data.
Gender
REQUIRED
Male
Female
Please fill out this field.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
Grade completed
REQUIRED
Please fill out this field.
Please enter valid data.
Allergies or medical conditions
REQUIRED
Please fill out this field.
Please enter valid data.
Registration 6
Child's Name
REQUIRED
Please fill out this field.
Please enter valid data.
Gender
REQUIRED
Male
Female
Please fill out this field.
Age
REQUIRED
Please fill out this field.
Please enter valid data.
Grade completed
REQUIRED
Please fill out this field.
Please enter valid data.
Allergies or medical conditions
REQUIRED
Please fill out this field.
Please enter valid data.
Parents/Guardians' Names
REQUIRED
Please fill out this field.
Please enter valid data.
Address
REQUIRED
Please fill out this field.
Please enter valid data.
City
REQUIRED
Please fill out this field.
Please enter valid data.
State
REQUIRED
AK
AL
AR
AS
AZ
CA
CO
CT
DC
DE
FL
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MH
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
PR
PW
RI
SC
SD
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
Please fill out this field.
Zip
REQUIRED
Please fill out this field.
Please enter a zip code.
Mother Phone Number
REQUIRED
Maximum 20 characters
Please fill out this field.
Please enter a phone number.
Father 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.
Emergency Contact
REQUIRED
Please fill out this field.
Please enter valid data.
Emergency contact phone number
REQUIRED
Maximum 20 characters
Please fill out this field.
Please enter a phone number.
I understand that reasonable precautions will be taken to safeguard the health and well being of the participants in this VBS and that I will be notified as soon as possible in the event of an emergency. In the case of sickness or an accident, I authorize and consent the VBS Team, or other associated volunteers of the VBS program to obtain medical care from a licensed physician, hospital, or medical clinic for my son/daughter in the event that myself or othe legal guardian(s) cannot be reached.
I Agree
Please select this field.
I hereby do release and forever discharge the Diocese of Sioux City, and Sacred Heart Parish from all manners of actions, claims which I or the child/children named above shall or may have for any reason, arising during my child's attendance of the VBS.
I Agree
Please select this field.
As parent/guardian, I understand that pictures and videos (individual and group) may be taken during the week of the summer VBS. I give permission for my child(ren)'s (named above) pictures to be shared on our Sacred Heart Parish website, Facebook page or other church related media.
I Agree
Please select this field.
By signing and dating, you will give permission for your child(ren) to attend the Sacred Heart Parish Summer VBS program.
Parent Signature (first and last name)
REQUIRED
Please fill out this field.
Please enter valid data.
Date
REQUIRED
Please fill out this field.
Please enter a date.
Submit
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