Creekwood Christian Church Vacation Bible School Registration Form
We are so glad that your children, ages 3 (potty-trained) through 5th grade would like to attend Vacation Bible School with us this summer at Creekwood. VBS will be the week of July 15-19 from 9:00am-12:00pm.

In order for your child to attend, please fill out this form, providing the information requested below to help us ensure that your child has a fun, safe, and meaningful experience. We're excited to spend the week with you!

Please complete a separate form for each child you are enrolling. Thank you!

Basic Information
Participant's Name: *
Your answer
Participant's Age: *
Your answer
Participant's T-Shirt Size:
Participant's Address: *
Your answer
Parent or Guardian's Name(s): *
Your answer
What email address is best to contact you? *
Your answer
What phone number is best to contact you? *
Your answer
Emergency Contact Information: *
Please provide name, relationship, and phone number for an emergency contact.
Your answer
Please list any allergies, medical issues, or medication considerations that our volunteer staff needs to be aware of: *
Your answer
How did you hear about CREEKWOOD VBS?
Your answer
Photo Release and Licensing Agreement
Do you give Creekwood Christian Church permission to use you or your child's name, likeness, or image in any printed or electronic material for the purpose of documenting, reporting, and promoting Interfaith Summer Camp? *
Please select a reply from the choices below.
Liability Release
By checking the box below, the undersigned adult, parent, or legal guardian agrees to indemnify and hold harmless Creekwood Christian Church, as well as our directors, volunteers, participants, and all persons connected herewith, from all actions, causes of actions, suits and any claims, demands, and liabilities whatsoever, both in law and equity. The terms hereof shall be binding on any and all executors, heirs, administrators, and assigns, and shall serve as an assumption of risk and general release for the above-named participant while participating in this event. *
Are you interested in serving as a volunteer for VBS? *
To complete this form, please type your name in the field below, to serve as your digital signature. *
Your answer
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