VBS 2024 Registration
Please fill out this form and click submit.
Parent's Name
*
Address
*
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Phone
*
Email
*
This address will receive a confirmation email
Will child(ren) need transportation?
*
Please select one option.
Yes
No
Select Option
Yes
No
Pick-up Address
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AK
AL
AP
AR
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AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
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TX
UT
VA
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WA
WI
WV
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YT
I hereby give my permission for my child to ride the van, participate in activities, and attend Cornerstone Baptist Church for Vacation Bible School. I understand that my child will be under adult supervision. I further understand that in signing this permission slip, I release and hold harmless Cornerstone Baptist Church. By signing this permission slip, I release and hold harmless its trustees, officers, employees, and any volunteers from any and all liabilities, claims, or demands for personal injury, sickness or death, as well as property damage and expenses. I authorize the staff or designated medical professionals and/or volunteers to administer emergency medical assistance if I cannot be reached.
*
Please select all that apply.
Yes
No
Child's Name
*
Birthdate
Child's Age
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Grade in Fall of 2024
*
Please select all that apply.
K5
1st
2nd
3rd
4th
5th
6th
Other
Allergies or Medical Concerns
*
Submit
Description
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