CBIC Church 2019 VBS Registration Form
Throw on your camera strap and buckle your seatbelt. VBS 2019 takes you on a wild adventure—with elephants and egrets, polar bears and penguins, cockatoos and crocodiles. As you seek out exotic animals, you’ll also find snapshots of real-life encounters with Jesus in Scripture. Kids go from bewildered to believing as they get In The Wild at this summer’s VBS.

Location: CBIC Church, 465 Center Street, Chambersburg, PA 17201
Dates: Sunday, June 9th - Thursday, June 13th
Time: 6:30 - 8:30pm
Ages: 4 years old (and potty trained) through children who just finished up 5th grade

Invite friends to join this adventure with you!

Childs Name: *
Your answer
How old is your child (grade is the grade just finished in 2018-2019 school year): *
Do we have permission to take photos of child and post them to social media? *
Does your child have any allergies or health concerns we should know about? If yes, please list below: *
Your answer
Parent/Guardian Name *
Your answer
Parent/Guardian Cell # *
Your answer
Parent Guardian Email Address: *
Your answer
Secondary Emergency Contact Name & Number:
Your answer
Do you agree to this Statement? I give my child(ren) permission to attend 2019 VBS at Chambersburg Brethren in Christ Church (CBIC). Once my child(ren) is in the care of CBIC, my child(ren) has my permission to participate in any or all of the activities. I understand that my child(ren) will participate in these activities at his / her own risk. While I am assured that CBIC will take any and all reasonable precautions to protect the safety of my child(ren), I understand that injuries can occur naturally during any activity. I consent that CBIC is neither the guarantor nor the insurer of my child’s safety. I understand that my child is ultimately taking part in this activity at his / her own risk. If I am not able to be reached in the event of an emergency, I give them permission to have my child(ren) treated by medical personnel. *
How did you hear about this event? *
Questions? Comments?
Your answer
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This form was created inside of Chambersburg Brethren in Christ Church.