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VBS Payments
VBS Payments
Patrice Abona
2019-02-27T10:52:56-05:00
This form is for PAYMENT ONLY. You must register first before filling out this form.
Have you already registered for VBS on the vbspro website?
*
Please Select An Option
Yes
No
You must register for the event before you can submit a payment. Please
click here
or visit
https://ecrc.us/vbs/
for more information.
Parent Name
*
First
Last
Phone
*
Email
*
Select week
*
July 13-17 Mother of God
July 20-24 at St. Thomas
July 27-31 at St. Thomas
August 3-7 at St. Thomas
Number of kids
*
The fee is $50/child. It will automatically calculate your total based on the number of children you select.
1 child
2 children
3 children
4 children
5 children
6 children
7 children
8 children
9 children
10 children
Children Names
*
Total
$0.00
Credit Card
American Express
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MasterCard
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Card Number
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
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2039
2040
Expiration Date
Security Code
Cardholder Name
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
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