Cross Roads Church
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VBS
Ministry to Students
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Register a child for VBS by filling out this form. Thanks!
Name of Child
*
First
Last
Enter the name of the child as they liked to be called. One child per form.
Grade Complete
*
Date Of Birth
*
Shirt Size
*
Are there any medical conditions or allergies that we need to be aware of?
*
No
Yes
If Yes, please list any medical conditions or allergies.
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Contact Phone Number
*
-
-
Please enter a contact phone number in case of emergency during VBS and if additional information is needed.
Your Name
*
First
Last
name of person submitting this registration.
Your Email
*
Enter your email for confirmation and VBS updates.
Emergency Contact
*
In case you cannot be reached, who should we contact in an emergency?
Emergency Phone Number
*
-
-
Please enter an alternative contact phone number in case of emergency during VBS and if additional information is needed.
Submit Registration
