Calvary Christian Church "Time Lab" VBS Registration
Calvary Christian Church is excited to host a week of VBS! Please complete the following Registration Information for each child. (Additional children may be added after submitting information for the first child.) This form is best filled out on a desktop or laptop computer-mobile devices may cause submission errors.
PARENT/GUARDIAN INFORMATION
Parent/Guardian Name *
Your answer
Address/City/State/Zipcode *
Your answer
Phone Number *
Your answer
Email *
Your answer
Your Home Church (if any)
Your answer
CHILD INFORMATION
Name of Child *
First & Last Name
Your answer
Date of Birth *
Month/Date/Year - (Children Must be age 4-12 years old by June 25th.)
Your answer
Male or Female (check one) *
Required
Will Your Child Be Attending all 5 days of VBS? (Mon-Thur 9am-1pm) / (Fri 4pm-8pm) *
Required
If Your Child CANNOT attend all 5 days of VBS, what days will your child NOT be attending?
MEDICAL INFORMATION
Does Your Child Have Any Food Allergies *
(i.e. Gluten, Dairy, Eggs, etc.)
Required
If yes, please describe below:
Your answer
Does your Child have any other allergies OR medical conditions *
(i.e. Asthma, Diabetes, Seasonal Allergies, etc.)
Required
If yes, please describe below
Your answer
EMERGENCY CONTACT
In case of emergency, who can we contact? *
First & Last Name
Your answer
Relationship to child *
(i.e. Father, Grandparent, Aunt, etc.)
Your answer
Phone Number *
Your answer
CONSENT & AGREEMENTS
Parent/Guardian Pickup
The security of your child is our top priority. Please complete this section to verify who will be picking your child from VBS.
Parents/guardians must inform Calvary Christian Church if there are changes to who is picking up their child on any day. The “Authorized Pick-Up Person” must be at least 18 years old and may be asked to provide a photo ID to the staff.

I hereby inform Calvary Christian Church that the people listed below are authorized to pick up the above named child from Time Lab VBS.

Authorized Pickup Person *
First & Last Name
Your answer
Pick Up Person's Relationship to child *
(i.e. Father, Grandparent, Aunt, Friend, etc.)
Your answer
Pick Up Person's Phone Number *
Your answer
2nd Authorized Pickup Person (if applicable)
First & Last Name
Your answer
2nd Pick Up Person's Relationship to child (if applicable)
(i.e. Father, Grandparent, Aunt, etc.)
Your answer
2nd Pick Up Person's Phone Number (if applicable)
Your answer
Medical Consent *
In the event that my child (listed above) becomes ill or sustains an injury at Calvary Christian Church’s VBS, I the undersigned, give my permission to the church and/or VBS l staff to take whatever steps are necessary to stop any bleeding and to administer first aid. In the event that I cannot be reached, I consent to emergency treatment for my child, which may include emergency care, hospital care, and the administration of drugs or medicine to my child upon the advice of a duly licensed physician and/or surgeon. I will not hold the church, its staff nor its volunteers liable in the event of injury or illness involving my child except in the case of gross negligence.
Required
PLEASE PRESS THE SUBMIT BUTTON BELOW
After you hit "SUBMIT" please scroll to the top of the this form and make sure you see the "Confirmation" message. You will also receive a confirmation email within 1 day of submitting your information.

If you do not receive a confirmation email within 1 day (or are having trouble with this form), please email calvary.ngkids@gmail.com to ensure your information has been submitted. Thank You!

Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service