VBS Volunteers

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  June 22-26, 2026 from 9:00 am – 12:00 pm
  Training: June 13 – 1:00 pm – 4:00 pm
  Workday: June 20 & 21 – Time: TBD
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Gender REQUIRED Please fill out this field.
  
  Date of Birth REQUIRED Please fill out this field. Please enter a date.
  
  Grade in 2026-2027 REQUIRED Please fill out this field.
  
  T-shirt size REQUIRED Please fill out this field.
  
  PARENT 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.
  
  Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  
  Text? REQUIRED Please fill out this field.
  
  Email REQUIRED Please fill out this field. Please enter an email address.
  
  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.
  
  EMERGENCY INFORMATION (when parent cannot be reached)
  
  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.
  
  Relation REQUIRED Please fill out this field. Please enter valid data.
  
  First Name Please enter valid data.
  
  Last Name Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Relation Please enter valid data.
  
  Health Insurance provider Please enter valid data.
  
  Policy number Please enter an integer (number).
  
  Physician name REQUIRED Please fill out this field. Please enter valid data.
  
  Phone Number Maximum 20 characters Please enter a phone number.
  
  Does your child have any special needs? Please enter valid data.
  
  Does your child have any allergies or medical concerns? (Alternative food should be provided by families) Please enter valid data.
  
  EMERGENCY HEALTH / MEDICAL INFORMATION AND CONSENT:
  In the event of an emergency, I, the undersigned parent/guardian of the child named on this form, hereby give permission to St. Rose of Lima Catholic Church, and their employees, agents, representatives, and adult volunteers, to arrange for and authorize emergency medical, dental, or surgical treatment for my child, as considered necessary by the attending physician. I wish to be advised prior to any further treatment by the hospital or doctor.
  CONSENT TO PARTICIPATE:
  By checking the box below, I consent to have my child participate in St. Rose’s VBS program and will allow photographs to be taken of my child to use for parish purposes only. My child’s picture may be taken for the church bulletin, website, for arts and crafts activities, and for promotion of future VBS programs at St. Rose of Lima.
  I Agree Please select this field.
  
  Please marked the preferred areas where you are interested in volunteering (you may not get any of your choices, we assign based on need)
  
  Preference #1 REQUIRED Please fill out this field.
  
  Preference #2 REQUIRED Please fill out this field.
  
  Preference #3 REQUIRED Please fill out this field.
  
  Preference #4 REQUIRED Please fill out this field.
  
  Preference #5 REQUIRED Please fill out this field.
  
  Submit
  
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ST. ROSE OF LIMA CATHOLIC CHURCH

Roseville, CA

VBS Volunteers