2019 ROAR! VBS Participant Registration
Welcome to the Participant Registration Form for ROAR! VBS at Central College Presbyterian Church in Westerville, Ohio.

We are so excited your child will be joining us! Our VBS runs from 6 - 8:30 PM, Sunday through Thursday, July 7 - 11, 2019. Central College Presbyterian Church is located at 975 S. Sunbury Rd., Westerville, OH 43081. If you have any VBS questions, please contact us at vbs@ccpc.us!

Please complete a separate registration form for each child you wish to register. Please note that registration is NOT COMPLETE until payment is made (see payment details at the end of the form). Registration is $20 per child up to a $50 family maximum charge.

Registration is FREE when an adult (18+) volunteers with us for the entire week! Please consider volunteering as a crew leader; the number of children we can register depends on the number of adult crew leaders who join us. We need YOU, and you don't want to miss this adventure!!

Email address *
Participant Information
Participant First Name *
Your answer
Participant Last Name *
Your answer
Participant Age *
(Age as of July 7, 2019)
Participant Gender *
Required
Participant Grade Completed in Spring 2019 *
(Grade just completed - participants through 4th grade only. 5th grade and up can volunteer!)
Allergies *
Please list/describe if applicable, or enter "None" if not.
Your answer
Are there any medical concerns we should be aware of?
If yes, please describe.
Your answer
Friend Request - you may request one friend that you would like your child placed with. We cannot guarantee crew assignments, but we will do our best!
Your answer
Additional questions or comments. You may also e-mail vbs@ccpc.us at any time with additional questions!
Your answer
Parent Information
Parent First Name *
Your answer
Parent Last Name *
Your answer
Parent Phone Number 1 *
Your answer
Parent Phone Number 2 *
Your answer
OPTIONAL: Additional E-mail address(es) for receiving VBS Communications
Your answer
Mailing Address *
Your answer
Are you a member of a local church? *
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact - Relationship to your family *
Your answer
Alternate Pickup Name
Your answer
Alternate Pickup Phone Number
Your answer
Alternate Pickup Name 2
Your answer
Alternate Pickup Phone Number 2
Your answer
CCPC VBS Shirts and CDs
A VBS T-shirt is INCLUDED in your child's registration! Please select the size below. *
VBS Music CD *
VBS Music CDs are $10 each. Please indicate if you would like to pre-order a CD. CDs will also be available for purchase during VBS week.
Payment Information
Registration Fees are $20 per child with a family maximum of $50. Registration includes a VBS T-shirt! CDs are $10 each, if you are interested.

Registration is FREE when an adult (18+) volunteers with us for the entire week! Please consider volunteering as a crew leader; the number of children we can register depends on the number of adult crew leaders who join us. We need YOU, and you don't want to miss this adventure!!

If paying by CHECK, please make checks out to "CCPC" with "VBS" in the memo line. Checks can be mailed to Central College Presbyterian Church, c/o Children's Ministries, 975 S. Sunbury Rd., Westerville, OH 43081, or dropped off in the church office.

If paying ONLINE by credit card, please access the payment system at the link below, which is also included in your confirmation message. Please use the same e-mail address in the payment system as you are using as your preferred parent e-mail address, so we can more easily connect registrations to payments.
Payment System Link:
https://www.eservicepayments.com/cgi-bin/Vanco_ver3.vps?appver3=tYgT1GfNxRUldiimjHMvOQ2tzXbaB5mJDzAdbsgNTPW1q4qJDDuf89STNCYkcYRM2evTpo0mld6BrVzd2nG0p-BkzVEUxvl-KaLYOHdJn5c=&ver=3

Registration Payment *
I will pay my registration fee:
Online Payment Contact Name - if paying online, please enter the first and last name for the online payment account. (Please see this link for instructions for the online payment system, if needed: https://drive.google.com/file/d/1sm0tG0qJQ9T59PYQWoKdKb-WvMGL1X0W/view?usp=sharing)
Your answer
Online Payment Contact E-mail Address - if paying online, please enter the e-mail address for the online payment account.
Your answer
If your child's registration is FREE along with an adult volunteer's week-long service, please list the name or names of volunteers below. To qualify for free registration, at least one volunteer for the entire week must be 18 years of age or older. THANK YOU for your time and energy!
Your answer
Authorization for Participation and Photo Release: *
In consideration of my child’s participation in the activities of CCPC Children’s Ministry, I do hereby declare myself and / or my child to be medically able to participate in the activities offered at the listed event(s). (I understand that there are risks which may include disabling injury and or death in all physical activities undertaken.) I agree to hold free from any liability CCPC Children’s Ministry and CCPC for myself and / or child connected in participating in church ministry events. I understand that all Children’s Ministry activities and events are supervised.In registering my child for a Children’s Ministry event at Central College Presbyterian Church, I hereby authorize its representatives and employees the right to use, reproduce and / or publish photographs and / or video that pertain to my child in connection to the event he/she is participating in without compensation. I understand that this material may be used in various publications, recruitment materials, broadcast public service advertising (PSAs) or for other related endeavors. This material may also appear on Central College Presbyterian Church’s Internet web page or on the CCPC- VBS private FaceBook page which is by invitation only. By signing this I understand and agree to the above statements.
Your answer
Any additional questions or comments? Please feel free to add them here or contact us at vbs@ccpc.us at any time.
Your answer
A copy of your responses will be emailed to the address you provided.
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