Valentine's Bible School (VBS) 2/17/18
This is the registration for the Valentine's Date Night VBS hosted by the Cornerstone Youth Group. We ask that you fill out this registration form to the best of your ability for the knowledge of our staff and your child's safety. This will be a night filled with fun for children of all ages (nursery staff will be available)!

Drop-off is at 4 PM and the evening's activities begin at 4:15 PM. Children will be divided into group based on their age. We will be playing games, making crafts, watching videos, reading a bible story, and more! This will be a night your children won't forget!

Please be reminded that we will have a "snack time" during our VBS night and we ask that parents provide their children with something for them to eat in a bag that is labeled with the child's name. Please refrain from bringing food that needs to be microwaved. Also, PLEASE DO NOT PACK NUTS IN YOUR CHILD'S BAG.

We can't wait to have a great night with your kids! Questions or concerns? Please email Nick Cirino at

Email address *
Child(ren)'s Names *
Your answer
Child(ren)'s Age(s) *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Contact Number *
Your answer
Other Emergency Contact Name and Number (Optional)
Your answer
Are there any allergies or medical conditions we should know about? If yes, please specify and label according to child
Your answer
Please Check All Boxes *
Signature (by typing your name below, you understand you are legally signing this permission slip for you child to participate in VBS)
Your answer
A copy of your responses will be emailed to the address you provided.
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