2026 VBS Camper Registration

VBS Camper Registration Form - $25 per child
Registration Closes May 29, 2026 or when we reach capacity.

Get ready for an exciting, faith-filled adventure this summer at Vacation Bible School!
Join us for Rainforest Falls VBS, where children will explore the beauty of God's creation
while growing in their faith through engaging Bible stories, music, crafts, games, and more.

Dates: June 8-12, 2026
Time: 9:00 AM - 12:00 PM

Who Can Attend: Children entering Kindergarten through 5th grade (Fall 2026)
Location: St. Luke Catholic Church

Each day is filled with high-energy activities and meaningful lessons designed to help children
know, love, and serve God in a fun and supportive environment.

Find our AMAZON WISHIST HERE if you can help with our supplies!

Can you save your toilet paper & paper towel cardboard rolls for us? Drop them at the Parish Office anytime.
The maximum number of form submissions has been reached. This form is currently not available.
- Parents Name: REQUIRED Please fill out this field. Please enter valid data.
- Primary Email REQUIRED Please fill out this field. Please enter an email address.
- Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
- Street 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.
- Are you a Registered Parishioner at St. Luke? Yes No
- If No, Please List Your Parish Here Please enter valid data.
- Authorized Pick Up List
  
  If you plan to have others pick up your child, please list information about this below, including full name of those picking up and dates you expect them to cover.
  
  Name/Phone/Date of Pickup
- Number of Campers 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.
  
  Student Grade Entering Fall 2026 REQUIRED Please fill out this field.
  
  Student Age on June 8, 2026 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Youth S Youth M Youth L Youth XL Please fill out this field.
  
  Please list any Allergy or Medical Needs for your Child
  
  Please list any Special Needs or Accommodations needed for your child. 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.
  
  Student Grade Entering Fall 2026 REQUIRED Please fill out this field.
  
  Student Age on June 8, 2026 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Youth S Youth M Youth L Youth XL Please fill out this field.
  
  Please list any Allergy or Medical Needs for your Child
  
  Please list any Special Needs or Accommodations needed for your child. 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.
  
  Student Grade Entering Fall 2026 REQUIRED Please fill out this field.
  
  Student Age on June 8, 2026 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Youth S Youth M Youth L Youth XL Please fill out this field.
  
  Please list any Allergy or Medical Needs for your Child
  
  Please list any Special Needs or Accommodations needed for your child. 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.
  
  Student Grade Entering Fall 2026 REQUIRED Please fill out this field.
  
  Student Age on June 8, 2026 REQUIRED Please fill out this field.
  
  T-Shirt Size REQUIRED Youth S Youth M Youth L Youth XL Please fill out this field.
  
  Please list any Allergy or Medical Needs for your Child
  
  Please list any Special Needs or Accommodations needed for your child. REQUIRED Please fill out this field.
- Of the following statements pertaining to medical matters, sign only in accordance with your wishes. Please type NA for irrelevant fields.
- Medical Matters
  
  Medical Matters
  Diocese of St. Augustine
  Catholic Center
  11625 Old St. Augustine Rd.
  Jacksonville, Fl 32258
  To my knowledge, my child is in good health, and I assume all responsibility for the health of my child.
  In the event of an emergency, I hereby give permission to Diocese of St. Augustine's employees, volunteers, or representatives to seek medical treatment for my child above named. In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by the Diocesan representatives or volunteers to hospitalize, secure proper treatment for, and order injection and/or anesthesia and/or surgery for my child above named.
  
  Select One: REQUIRED I Agree I Disagree Please fill out this field.
- Doctor & Medications
  
  Family Doctor 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.
  
  Family Health Plan Carrier REQUIRED Please fill out this field. Please enter valid data.
  
  Policy Number REQUIRED Please fill out this field. Please enter valid data.
  
  I make the following exception:
  
  My Child's Medications/ Dosages: please include Medication/Dose/Dr.
- Emergency Contact
  
  If I cannot be reached in an emergency, I hereby give permission to the physician selected by the Diocesan representatives or volunteers to hospitalize, secure proper treatment for, and to order injection and / or anesthesia and / or surgery for my child above named.
  
  Select One REQUIRED Agree Disagree Please fill out this field.
  
  In the event of an emergency, if you are unable to reach me at the above number, contact
  
  First Name REQUIRED Please fill out this field. Please enter valid data.
  
  Last Name REQUIRED Please fill out this field. Please enter valid data.
  
  Relationship 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.
- Other Medical Treatment
  
  OTHER MEDICAL TREATMENT: In the event it comes to the attention of the Diocese of St. Augustine’s employees, volunteers, or representatives that my child becomes ill with symptoms such as headache, vomiting, sore throat, fever, or diarrhea, I hereby give permission for over-the-counter medication to be administered to my child according to directions.
  
  Select One: REQUIRED I Agree I Disagree Please fill out this field.
- Media Release
  
  Diocese of St. Augustine |Photography and Media Release Form for Minor Children
  
  Without compensation, I hereby grant the Catholic Diocese of St. Augustine (the “Diocese of St. Augustine”), its ministries, parishes, schools and other affiliated entities, permission to record my child’s appearance, physical likeness and/or voice on videotape, on film, or digital video disk, or other means, and/or take photographs of my child. Notwithstanding any prohibition as may be contained in Section 540.08, Florida Statutes, I hereby freely and voluntarily
  consent to the use, reproduction, and distribution of photographs, video recordings or other media capturing my child’s image, physical likeness, or voice for an indefinite period of time or until such time I expressly revoke my consent in writing. These materials may include, but are not limited to news, editorial content, publications, promotional materials, electronic
  media (websites, social media channels, podcasts, videos), and/or printed brochures.
  In addition, I understand and agree that:
  * The Diocese of St. Augustine, its ministries, parishes, schools, and other affiliated entities may alter, edit or modify these materials as needed, without restriction.
  * The Diocese of St. Augustine retains the sole ownership and right to copyright any such materials.
  * My consent is voluntary, and I waive any rights to inspect or approve the finished products or the specific use of such
  materials.
  
  I agree to hold the Diocese of St. Augustine, the Bishop of the Diocese of St. Augustine, its employees and agents, and any media outlet or representatives involved in the creation of distribution of the materials harmless against claim, liability, loss, or damage caused by, or arising from any claims, demands or liability arising from or related the creation, use, production, or distribution of these materials. This Photography and Media Release Form for Minor Children is binding and applies to any claims of defamation, invasion of privacy, or rights of publicity. I have read this Photography and Media Release Form for Minor Children before signing and fully understand the contents, meaning, and impact of this release. I understand that I am free to address any specific questions and have done so prior to signing this release.
  
  Diocese of St. Augustine Catholic Center Last updated: 2/6/25
  Address: 11625 Old St. Augustine Road, Jacksonville, FL 32258
  Phone: (904) 262-3200
  
  Select One: REQUIRED I Agree I Disagree Please fill out this field.
- After you click SUBMIT below, the form will take you to our payment page, please use the VBS button to complete online payment. Thank you!
Submit