2024 VBS Child Registration

Family Information

Parent's Name

Parent's Email

This address will receive a confirmation email

Parent's Cell Phone

Address

Name of the church you attend (if any)

Child 1

Child's First and Last Name

Gender

Male Female

Child's Birthdate

Child's Grade in Fall 2024

Any allergies or other important information?

Child 2

Please answer all the questions in this section if you need to register another child in your family.

First and Last Name

Gender Male Female

Child's Birthdate

Child's Grade in Fall 2024

Any allergies or other important information?

Child 3

Please answer all the questions in this section if you need to register another child in your family.

Child's First and Last Name

Child's Gender Male Female

Child's Birthdate

Grade in Fall 2024

Any allergies or other important information?

Child 4

Please answer all the questions in this section if you need to register another child in your family.

Child's Name

Child's Gender Male Female

Child's Birthdate

Child's Grade in Fall 2024

Any allergies or other important information?

Before You Finish...

Please mark "YES" to agree to the following statements.

I agree not to hold CenterPoint Bible Church, its paid, or volunteer staff responsible for injuries incurred by my child. I give permission for CBC to obtain emergency medical services on behalf of my child if needed. CBC will attempt to contact the emergency contact indicated, but in the event it becomes impossible, CBC will contact the appropriate emergency personnel.

Yes

I understand that my child may be photographed by church staff during activities associated with Vacation Bible School while at CenterPoint Bible Church and that my child's photo may appear in a short video to be viewed by parents at the closing on Friday evening. Photos will not be used in other ways without permission.

Yes

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2024 VBS Child Registration

Description

Please Fix the Following