2026 Vacation Bible School Registration Application

: 2026 VACATION BIBLE SCHOOL REGISTRATION APPLICATION
: June 16-18, 2026 | 5:30-7:30 PM | Parish Activity Center | Vacation Bible School is free to ICCC family members with children, 4-12 years of age

: CAMPER'S INFORMATION
First Name
Last Name
Gender
Date of Birth (MM/DD/YYYY)
Home Address (Include Apartment Number, If Applicable)
City/State/Zip Code
Last Grade Completed in Academic Year 2025-2026
Any Food/Drink Allergies? (Identify All that Apply)
What "Other" Food/Drink Allergies? (If Applicable)

: PARENT'S INFORMATION
Which Parent? (If You Will Serve as Primary Contact)
First Name
Last Name
Preferred Phone Contact (Area Code + 000-0000)
Type of Preferred Phone Contact
Email Address
Will You Serve as Emergency Contact Too?

: EMERGENCY CONTACT'S INFORMATION (If Other Than Parent Above)
Relationship to Camper
Who Are You? (If Chose "Other" Relationship to Camper)
First Name
Last Name
Preferred Phone Contact (Area Code + 000-0000)
Type of Phone Contact
Email Address

: LIABILITY WAIVER
As the Primary Parent or Legal Guardian--I waive, release and discharge the pastor, employees, and volunteers of Immaculate Conception Catholic Church (Baton Rouge) and its Vacation Bible School staff from any and all liability that may arise from illness, negligence, or personal injury/death to my child (i.e., the camper), and property damage or thief to my child's belongings (i.e., the camper) while he or she is on the church's premises before, after, or during any Vacation Bible School activities.: Yes

: PHOTO/VIDEO RELEASE
As the Primary Parent or Legal Guardian--I give permission to the pastor, employees, and volunteers of Immaculate Conception Catholic Church (Baton Rouge) and its Vacation Bible School staff to take, display, and post Vacation Bible School-related photos and/or videos of my child (i.e., the camper). I consent to these photos and/or videos being posted to the church's website, Facebook page, or inside the church or Parish Activity Center. NOTE: All Vacation Bible School-related photos and/or videos are considered church property and will be used or displayed with discretion and appropriateness.

: AUTHORIZED PICK-UP PERSON
: As a safety precaution, please identify the person(s) authorized to pick-up your child (the camper) at the end of each day of Vacation Bible School.

All campers must be signed-in and signed-out by an Authorized Pick-Up Person every day of Vacation Bible School.
PICK-UP PERSON #1: First Name
PICK-UP PERSON #1: Last Name
PICK-UP PERSON #1: Relationship to Camper
Who Are You? (If Chose "Other" Relationship to Camper)
PICK-UP PERSON #2: First Name
PICK-UP PERSON #2: Last Name
PICK-UP PERSON #2: Relationship to Camper
Who Are You? (If Chose "Other" Relationship to Camper)

: The information submitted on this application is confidential and will be used for the sole purposes of the Diocese of Baton Rouge's Office of Child and Youth Protection and Immaculate Conception Catholic Church (Baton Rouge) and its two entities--Parish School of Religion and Vacation Bible School.

A Vacation Bible School Registration Application is required for each attending camper, 4-12 years of age.

2026 Vacation Bible School Registration Application

2026 VACATION BIBLE SCHOOL REGISTRATION APPLICATION

CAMPER'S INFORMATION

PARENT'S INFORMATION

EMERGENCY CONTACT'S INFORMATION (If Other Than Parent Above)

LIABILITY WAIVER

PHOTO/VIDEO RELEASE

AUTHORIZED PICK-UP PERSON

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