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Parishioner Portal
Home
Live
Parishioner Portal
Parish Life
300 Club
News
Bulletin
Office of Outreach Ministry
Faith Formation
Parish Prayer List
Funerals
Planned Giving
Membership Information
Sacraments
Baptism
Matrimony
Holy Orders
Calendar
Contact
Vacation Bible School
Registration
Monday, July 14 2025 – Friday, July 18, 2025
5:30pm – 8:00pm
Guardian Details
Mother
(Required)
First
Last
Mother Phone
(Required)
Is the mother a custodial parent?
(Required)
Yes
No
Father
(Required)
First
Last
Father Phone
(Required)
Is the father a custodial parent?
(Required)
Yes
No
Family Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Emergency Contact
Emergency Contact Name
(Required)
First
Last
Emergency Contact Phone
(Required)
Emergency Contact Relationship
(Required)
Names of People Authorized for Pickup
(Required)
Child's Information
Please add a new entry for each child
Child's Name
Actions
Edit
Delete
There are no
Children.
Add Child
Maximum number of children reached.
Legal
General
(Required)
I agree to the general policy
I give my consent for my child(ren) to attend meetings, activities and events, both on site and off site. I will be provided specific event information in advance of any off-site activity.
Release
(Required)
I agree to the release policy
To the fullest extent permitted by law, I release Immaculate Heart of Mary Parish, its trustees, officers, directors, employees, agents and representatives from any illness, injury, harm, damage or death which may occur to my minor child while participating in the activity and agree to save and hold harmless Immaculate Heart of Mary Parish, its employees, volunteers and representatives from any claims arising out of my minor child’s participation in the activity.
Medical
(Required)
I agree to the medical policy.
In the event of a medical emergency and when a contact cannot be made to me and/or the emergency contact listed, I give my permission for my child(ren) to receive appropriate medical attention. In the event of an emergency or accident, I release Immaculate Heart of Mary Parish, its employees and volunteers, and all those related to it, from any liability. I have provided emergency contacts and am assured that I will be contacted as soon as possible in the event of an emergency.
Transportation
(Required)
I agree to the transportation policy.
Should transportation be needed, I agree to allow my child(ren) to ride with church staff or volunteers. Appropriate safety standards will be maintained and children will always be provided seatbelts. If no such permission is granted, I agree to transport my child(ren) to and from any offsite event. I understand that it is my child(ren)’s responsibility to wear his/her seatbelt.
Photograph release
(Required)
I agree to the photography policy.
Photos may be taken during VBS, Sunday school, worship, youth group events, or other church activities. I grant permission for Immaculate Heart of Mary Parish to post photos including my child(ren) on its website, social media or in other church publications.
Signature
(Required)
Today's Date
(Required)
MM slash DD slash YYYY
Submitter's Name
(Required)
First
Last
Submitter's Email
(Required)
Enter Email
Confirm Email
Phone
This field is for validation purposes and should be left unchanged.
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