Registration Form
-
* required fields
*Child's Name:
* Child's Age:
* Last school grade completed:
Child's Name:
Child's Age:
Last school grade completed:
Child's Name:
Child's Age:
Last school grade completed:
* Parent/Gaurdian Name:
* Address:
* Home Phone
(xxx-xxxx)
:
Cell/Work Phone
(xxx-xxxx)
:
* Email Address:
Home Congregation
(if any)
:
In case of emergency (when the parent/guardian cannot be reached) please contact:
* Name:
* Phone Number:
* Relationship to Child:
* Children's Allergies
(List all that apply)
:
Person responsible for picking up this/these children at the end of each day of VBS (if it is not yourself)
Name:
Phone Number:
By signing this form, I give permission for my child(ren) to attend and release the organizers from any liability. By signing this form, I give permission for my child(ren) to be included in pictures through video, photo/digital camera.
Online signature consists of entering your initials below.
* Initials:
*We are committed to safeguarding the information provided on this form. It will not be shared beyond Cross Pointe ministries.
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Cross Pointe Family Church
. All rights reserved
.
