The Great Treasure Hunt! VBS 2019 Crossgate Church
July 17th, 24th, 31st and August 10th, 2019
Email address *
Parent's Name *
(You will add your child/children later in this form.) Please place last name first. (For example: Smith, Tina)
Your answer
Phone Number *
Please provide the phone number where we could reach you easiest.
Your answer
Email *
Your answer
Address *
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Child's Name *
If you have more than one child, please enter 1 at a time. You can add another child below. After adding your last child, please go to the next question regarding any special notes or instructions. If you have more than 4 children please submit another form to accommodate them all.
Your answer
Child's Current Age *
Child's name (2)
Your answer
Child's Current Age
Child's name (3)
Your answer
Child's Current Age
Child's name (4)
Your answer
Child's Current Age
If any of your children have special needs or instructions that we need to be aware of to better care for them, please note these items here. *
(For example, allergies, medical information, etc.) Please specify which child if you have multiple children. If there are no special needs please just write "None".
Your answer
Please select the dates that your child/children will be attending VBS *
If something happens and your child is not able to attend, we understand.
Required
Is there anything else we need to know?
For example, if you have multiple children and only some can come on certain days. This will let you explain something further if you do not have the space elsewhere.
Your answer
Please READ and SIGN the MEDICAL RELEASE waiver below electronically by typing "Yes" and Your FIRST AND LAST name. *
I give permission for my son/daughter/children to participate in the VBS sponsored by Crossgate Church, July 17th, 24th, 31st and August 10, 2019. In the event of an emergency, the leaders have permission to have my child medically treated in whatever manner needed. I hereby release Crossgate Church and its representatives from any liability as a result of my child’s participation. This waiver covers the child/children listed above.
Your answer
Please READ and SIGN the PHOTO RELEASE WAIVER below electronically by typing "Yes" and your FIRST AND LAST name. (If the answer is no please type "no") *
I also give permission for my son/daughter/children, as participant/(s) in the VBS at Crossgate Church, July 17th, 24th, 31st and August 10th, 2019, to be photographed or captured on video during the VBS program and activities. I hereby grant full permission to Crossgate Church to use photographs or videos - in print, electronic, online, or other public media - of the child/children registered on this form and further release Crossgate Church from any and all liability connected with the authorized use of words and image of the child/children registered on this form. This waiver covers the child/children listed above.
Your answer
Please list your home church. If you don't have a home church, please put "none".
Thank you for filling out our VBS form! We will see you and your child soon!
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How did you hear about our VBS? *
Please check at least one item.
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