Rainforest Adventure VBS 2018
Registration form for June 18-21, 2018 VBS -- Central Park Church & Park Church
Please fill out a separate registration form for each child
Email address *
Child's Last Name *
Your answer
Child's First Name *
Your answer
Child's Address: Street *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Grade Child will start in September 2018 *
Parent/Guardian Full Name *
Your answer
Parent Phone Number *
Your answer
Parent Email Address
Your answer
Emergency Contact Name & Relationship *
Your answer
Emergency Contact Phone Number *
Your answer
Does your child have any special needs (allergies, disabilities, etc.) which you would like us to know about as they participate in Rainforest Adventure VBS 2018?
Your answer
My child has permission to participate in Rainforest Adventure VBS 2018. I give permission for medical attention to be provided for my child in the event of accident or illness with the understanding that every effort will be made to contact me and the emergency contact at the above numbers. I also hereby release Central Park Church & Park Church, their staff and volunteers, of any and all liability for any loss, injury or property damage which may result while participating in Rainforest Adventure VBS 2018. *
Required
Pictures: I give permission for pictures of my child to appear in publications of Central Park Church or Park Church, including websites. Names would not be included in any publications. *
Required
A copy of your responses will be emailed to the address you provided.
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